Medicare Health Care Quality (MHCQ) Demonstration Programs are designed to examine the extent to which major, multi-faceted changes to traditional Medicare's health delivery and financing systems lead to improvements in the quality of care provided to Medicare beneficiaries, without increasing total program expenditures. The North Carolina Community Care Networks (NC-CCN) project, implemented under MHQC, will build on a Primary Care case Management program that was developed by the North Carolina's Medicaid program that currently serves the state's Medicaid-only, low-income, and uninsured populations. Under the demonstration, the same coordination of care efforts will be expanded to the dually eligible and Medicare-only population.
Under the demonstration, NC-CCN will implement four-pronged strategy to improve care delivery:
• Assign beneficiaries to participating primary care physician practices. These practices will be responsible for coordinating care and improving performance on a defined set of quality measures.
• Provide community-based care coordination services to participating practices and beneficiaries.
• Expand the current case management information system to include the dually eligible and Medicare only population.
• Develop and implement a performance measurement, reporting, and incentive program to recognize and encourage improvements in performance by participating physicians. At least half of any shared savings payment made to NC-CCN will be contingent on achieving targets on a set of performance measures
