North Carolina

North Carolina established one of the first statewide PCMH networks in the country through Community Care of North Carolina (CCNC). CCNC served as an early model for improving health care delivery through a strong model of community-based primary care teams in partnership with public health and both public and private payers of heatlh care. CCNC leaders describe the evolution of the program and key partnerships on their website. Supported through legislation (Session Law 2010-31), CCNC continues to serve as the anchor program in North Carolina for most of its health improvement and cost-containment efforts including Care Coordination for Children (CC4C), Dual-eligible initiative, Multi-payer Advanced Primary Care Practice Project (MAPCP), and Palliative Care Initiative, just to name a few. All of these programs continue to build on the CCNC medical home approach to care. The state's participation in the MAPCP demonstration ended 12/31/2014.

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
No
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
9,638,800
Uninsured Population:
16%
Total Medicaid Spending FY 2013: 
$11.9 Billion 
Overweight/Obese Adults:
66.1%
Poor Mental Health among Adults: 
30.4%
Medicaid Expansion: 
No

First in Health

First in Health is a public-private partnership that will enable private-sector employers to tap into a “medical home” infrastructure created for Medicaid recipients by a nonprofit organization on behalf of the State of North Carolina in the last ten years.

Medicaid Reform in a House Divided and MCO, ACO…Who Cares?

So, now, here, in this extremely polarized society, our NC General Assembly is tackling one of our most important and most divisive issues…Medicaid Reform.

But, you say, “Knicole, our General Assembly is an overwhelming Republican majority.  Our Governor is Republican.  How can this vast and deep political polarization prevent NC from creating a new, better, non-broken Medicaid system?”

News Author: 
Knicole Emanuel

Doctors streamline healthcare process with Patient-Centered Medical Home

Healthcare can be very confusing and expensive.

But some doctors are trying to streamline the process and help the patient save time and money.

It’s called Patient-Centered Medical Home and two physicians stopped by FOX8 on Tuesday to talk about it — one physician with Eagle Physicians, the other with Triad Healthcare Network.

Eagle is the first medical group in the area to be PCMH-certified and this new way of caring for patients has a lot of advantages to offer.

UNC Better Back Care Medical Neighborhood

UNC’s Better Back Care program creates a new model of care for patients with back pain that will improve the patient’s experience and outcomes, reduce the cost of care and deliver an innovative method of financing care.

Health Insurers Are Trying New Payment Models, Study Shows

Health insurers are experimenting with new formulas for reimbursing doctors and hospitals, slowly moving away from the traditional approach of basing payments on the numbers of tests and procedures performed, according to a survey of Blue Cross insurers, among the most dominant plans in the country. The survey, released on Wednesday by the plans’ trade association, estimates that $1 out of every $5 in reimbursements is being paid under an arrangement in which providers are rewarded for improving care and lowering costs.

News Author: 
Reed Abelson

Humana medical home program - Cornerstone Health Care

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Catawba Valley Medical Center

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Caromont Medical Group

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Duke University Affiliated Physicians

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

Humana medical home program - Novant

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

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