The Cooper administration’s version of the state Department of Health and Human Services will conduct its own listening tour about how to reform Medicaid and the N.C. Health Choice programs.
Dr. Mandy Cohen, the state’s health secretary, announced the launching of a one-month period for comments and ideas that expires May 25.
That includes a public meeting set for 5:30 to 7:30 p.m. tonight at the Guilford County DHHS Building, 1203 Maple St. in Greensboro.
“Our department values an open and collaborative process with our stakeholder community to build a strong, efficient Medicaid program,” Cohen said.
The listening period comes nearly a year after the McCrory administration submitted June 1 a Medicaid waiver request to the federal Centers of Medicare and Medicaid Services.
The request proposes a hybrid public-and private-sector reform solution that eventually would combine physical and behavioral health care. DHHS projects about $400 million in savings in the first five years of implementation.
The Medicaid waiver request was supposed to start a three- to five-year process with an end goal of Medicaid oversight being placed in the hands of three statewide managed care organizations, likely pre-paid health plans from commercial insurers, and up to 12 provider-led entities, likely to involve not-for-profit health care systems.
Each of the six regions established by the reform legislation could have up to five of these groups providing services.
However, holding up Medicaid waiver negotiations are the on-again, off-again attempts by the Republican-controlled Congress to repeal and replace the Affordable Care Act.
Cohen said she thought it was appropriate for current DHHS officials to get their own direct feedback while the waiver process was on hold. She said the goal is determining where the level of support is for the current request and where it could be improved, updated and amended.
The McCrory administration conducted a 12-forum tour, including a contentious event in April 2016 in Winston-Salem and several other localities, before submitting the waiver request.
At most settings, McCrory’s DHHS officials heard pleadings to expand Medicaid to more than 500,000 North Carolinians, raising the potential total to nearly 2.4 million.
McCrory and Republican legislative leaders declined to heed those requests, saying in large part they didn’t trust the federal government to continue to provide at least a 90 percent match to state funding for annual Medicaid expansion administrative costs.
Before accepting the job as state health secretary, Cohen served as a top CMS administrator of President Barack Obama’s health-care overhaul.
“Time has passed and issues have evolved in the past year,” Cohen said.
“It’s a good moment in time to hear all the voices across the state, and if needed, makes changes (to the waiver request) to reflect that input.”
Dave Richard, the state’s deputy secretary for Medicaid and a McCrory administration holdover, said that “clearly those public hearings across the state (in 2016) were incredibly valuable.
“But that was a year ago and the health care environment has changed significantly in the past year. We need more input from community stakeholders and with the new DHHS team to build upon the previous public comment.”
DHHS is requesting feedback on seven specific topics. They address how to:
- Care for the whole person to improve physical and mental health;
- Help doctors and other health care providers transition to managed care;
- Manage care to improve overall health, not only to treat injury or illness;
- Consider the impact of income, housing, lifestyle and other social circumstances on health and health care services;
- Improve quality of care;
- Pay for value, and;
- Increase access to care and treat substance use disorder.
Cohen said earlier feedback helped determine these seven topics. “They hit on some core areas to make the program as strong as possible,” Cohen said.
Cohen said she is particularly interested in gaining feedback on how to effectively increase and enhance Medicaid services while expansion talks are in limbo.
Cohen said Republican legislative leaders had input and “helped shape some of the questions” being asked for feedback.
Democratic Gov. Roy Cooper and Republican legislative leaders are butting heads in federal court over Cooper’s Medicaid expansion plan.
Cohen deflected questions about her opinion on the legal battle, but said she had confidence in talks with Republican legislative leaders given her unanimous confirmation by the Senate.
On April 8, Rep. Donny Lambeth, R-Forsyth, and author of the 2016 Republican legislative initiative on Medicaid reform, submitted House Bill 662, which would expand the state program, but require “participant contributions.”
Lambeth said the expansion initiative would work “more like an insurance product for those working who can pay a portion of the cost, and the benefits and coverage are built around preventive and wellness care.”
For example, participants must follow protocols for routine physicals and screenings to improve their health if they have conditions such as diabetes, overweight, etc.”