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North Carolina

Addressing Access to Primary Care:  Community Care of North Carolina

Community Care of North Carolina (CCNC) develops local networks of primary care providers to coordinate prevention, treatment, referral, and other services for Medicaid enrollees. The goals of CCNC are to increase access to care, promote community-based systems of care, enhance care management, and improve quality and cost effectiveness. The program builds on an earlier program, Carolina Access, the statewide primary care case management (PCCM) program, which connects Medicaid enrollees with a medical home that provides primary care.

Providers who serve Medicaid, Health Choice (North Carolina’s SCHIP) and soon NC Kids’ Care enrollees receive a small monthly fee (at this time $2 per enrollee) to provide case management services to their patients. Through CCNC and Carolina Access, primary care providers are able to work cooperatively with one another, with other community providers and with case managers in these networks to develop the tools, information and support needed to meet the health care needs of individuals enrolled in Medicaid, Health Choice and ultimately NC Kids’ Care. Elements of the program include:

• Direction on care management activities from both medical and administrative committees for providers;
• Dedicated case managers and care coordination services for patients;
• Regular reporting to allow networks to monitor their quality improvement progress;
• A physician incentive program to help spread the quality improvement initiatives of the CCNC; and
• A program called Assuring Better Child Health and Development (ABCD) that focuses on better identification, referral and treatment of children with potential developmental disorders.

Results: North Carolina has seen a steady increase of children being screened for and receiving and early intervention services as a result of the ABCD program operated by CCNC. An evaluation conducted by the Commonwealth Fund in 2004 reported that before the program began in 2000 less than 15% of Medicaid and SCHIP children received developmental screens, compared with 85% in 2005. In addition, the state has realized cost-savings from the program. A study conducted by Mercer Human Resources Consulting Group found that in fiscal year 2004, the program saved North Carolina $124 million.

For more information:

Visit the Community Care of North Carolina Web site at www.communitycarenc.com.

Read Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid from the Kaiser Commission on Medicaid and the Uninsured.