Medicaid overhaul aimed at reducing $13 billion price tag - Greenville, NC | News | Weather | Sports - WNCT.com

Medicaid overhaul aimed at reducing $13 billion price tag

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Governor Pat McCrory announced his plans to change Medicaid in North Carolina.  He's calling it the Partnership for a Healthy North Carolina.
In a news conference Wednesday, he said he's trying to hold down the spiraling costs of giving health care to the elderly and disabled.

"I haven't had Medicaid in so many years and I keep getting denied and denied, denied, denied."

Connie Carmon knows all too well the short-comings of North Carolina's Medicaid program but that doesn't stop her from applying, saying it's assistance she badly needs.

"If my kids receive Medicaid, I feel like I should receive Medicaid but I get denied but my children don't and I don't understand that," said Carmon.

On Wednesday, Governor Pat McCrory echoed Carmon's sentiment, calling the system overly complex with three "silos" that caused uncertainty and confusion with patients and doctors.

"It is often difficult for people, the people who are in need of this care so desperately, to know where to get the services that they must have," said McCrory.

McCrory said his reform will make the health care more comprehensive, concentrating on the individual as a whole but what does that mean for people on Medicaid and others like Connie Carmon.

First, the reform framework does not decrease the available benefits. You'll still get all the assistance you normally do.

Second, there are no changes to Medicaid eligibility. The requirement will not change.

Third and finally, the reform will provide uniformity across all health care through "Comprehensive Care Entities." Those entities are one of the biggest change to Medicaid.

The bulk of the reform concentrates on those Comprehensive Care Entities or "CCE".

They're care providers contracted by the state and given a set allotment of Medicaid money.

If their costs go over that allotment, the CCE has to come up with the difference, not the state or the patients.

State leaders say the plan will reduce the rising cost to taxpayers and eliminate administrative road blocks that frustrated doctors who accept Medicaid patients.

It'll all go into effect in 2015 and you can find the full breakdown.    

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