North Carolina tests medicaid savings program

North Carolina is leading a pilot project designed to determine if Medicaid management can also create savings in the private sector. According to an announcement today, the project will be a public-private partnership called, “First in Health.” Private pharmaceutical companies and insurers will be working with state health care providers to apply the state’s Medicaid management plan to private programs to determine if additional Medicaid money can be saved.

GlaxoSmithKline, SAS Institute, Kerr Drug, and Blue Cross and Blue Shield of North Carolina are in the pilot project together. They will work with Community Care of North Carolina (CCNC), the organization that coordinates care for the state’s Medicaid recipients. CCNC saved state state almost two billion in Medicaid funds from 2007-2010. Pilot participants are hoping to reap this level of savings by applying the best practices from CCNC’s program to their Medicaid practice.

Essentially, CCNC helps individuals on Medicaid navigate the health system through a combination of direct communication and health IT to streamline how Medicaid recipients get served. By streamlining the overall process, CCNC saves the state money by ensuring individuals are on a health care schedule that ensures prevention and helps to avoid costly emergency visits.

CCNC offers this coordinated care approach as a plan that Medicaid recipients can sign up for. Under the First in Health project, companies involved will give this plan as an additional option to their employees. State employees will also get access to the plan in a phased approach through 2012.

Health IT support will be provided by SAS Institute and the project is being observed by the Brookings Institution. Brookings will monitor the length of the pilot and issue a report on its overall effectiveness on Medicaid in the state. If the plan is effective, it is expected to be used as a Medicaid management model in other states.

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