BACKGROUND
CCNC is a managed primary care program that served approximately 1.3 million of approximately 1.5 million Medicaid beneficiaries in the state as of December 31, 2012.
Under CCNC, eligible beneficiaries join “medical homes,” which coordinate patients’ healthcare services. Primary care services are managed through the medical home, and access to specialty care is coordinated through the primary care physician. Each patient has access to a case manager to ensure individualized care. CCNC also provides health education to its plan members and assists them in maximizing their own health care through self-management.
The study population is limited to non-elderly, non-dual Medicaid beneficiaries. Dual eligible beneficiaries are individuals who receive full Medicaid benefits but also receive assistance from Medicare. The majority of dual eligibles meet the Medicare eligibility requirement based on age (65 and older). For these members, Medicaid is the payer of last resort, paying for long-term care or other costs that Medicare does not cover. Dual eligible beneficiaries were eliminated from the study population because significant portions of Medicare claim payments and records were not available.
KEY FINDINGS