A plan by Gov. Pat McCrory to reshape the state’s Medicaid program is on the radar of existing providers such as Community Care of the Lower Cape Fear (CCLCF).

The plan, which the governor announced in April, focuses on having managed care companies offer health care plans to low-income, disabled and elderly clients. The 14 Community Care of North Carolina networks operate as a delivery system for N.C. Medicaid, including CCLCF.

“It’s pretty early” to predict how the governor’s proposal will impact CCLCF, organization executive director Lydia Newman said.

Community Care of North Carolina helps manage the care of about 75 percent of patients enrolled in Medicaid statewide but only impacts about 55 percent of what is spent on Medicaid patients, Newman said.

North Carolina is already first in the nation in controlling Medicaid growth, she said.

“It will probably be an evolving news story. It’s going to take a couple years to implement such a thing,” Newman said.

The average annual Medicaid spending growth in North Carolina was 3.5 percent from 2007 to 2010, the lowest in the country, CCLCF spokeswoman Beth Adams said in an email response to questions.

“Most of this cost containment was achieved by Community Care of North Carolina enrolling the aged, blind and disabled, the sickest and most costly of the Medicaid population into our care management system,” Adams said.

“We certainly support the goals of coordinated care and improved budget predictability, and we look forward to working with the administration to help them craft a more comprehensive system to better serve the poorest and most vulnerable citizens of North Carolina.”

Services such as mental health care, long-term care, durable medical equipment, home health and personal care services “remain outside the control of Community Care of North Carolina,” Adams said.

She said one of the “key distinguishers” of Community Care of North Carolina “is our local, nonprofit infrastructure that allows us to directly partner with providers and patients in very tangible ways to improve the health of the population we serve, rather than cutting services and reimbursements to simply reduce costs.”

Adams said CCLCF’s approach focuses on:

• Coordination of patient care to reduce unnecessary illness and complications in care.

• “Boots-on-the-ground” care management “that helps managers reduce fragmentation and confusion across multiple providers.”

• Using a quality improvement team that works with primary care providers to adopt “nationally proven, evidence-based improvement strategies” to help them provide better care to their patients.

• Using a team of pharmacists to help ensure patient medications are correct, don’t conflict with each other and help patients understand how to take medications.

• Using a sophisticated statewide Informatics Center containing health care claims data provided by Medicaid, along with health information about CCLCF patients obtained directly from providers and care managers.

Novant, Cigna launch accountable care program

Cigna and Novant Health, an integrated system of hospitals and physician practices that includes Novant Health Brunswick Medical Center, have launched a collaborative accountable care initiative.

The program, which includes registered nurse care coordinators aligned with Cigna case managers, went into effect April 1.

Collaborative accountable care (CAC) is Cigna’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs.

The program will benefit more than 60,000 people covered by a Cigna health plan who receive care from a Novant Health physician in communities throughout the Carolinas, making it Cigna’s largest CAC nationally. 

Coupled with Novant Medical Group practices that are certified as patient-centered medical homes by the National Committee for Quality Assurance, “the Cigna CAC is a complementary pairing to keep our focus on patient care and coordination,” Carl Armato, CEO of Novant Health, said in a news release.

Under the program, Novant Health monitors and coordinates all aspects of an individual’s medical care. Patients continue to go to their current physician and automatically receive the benefits of the program.

Many patients using Novant Medical Group physicians will be managed using the EPIC electronic medical record system installed in practices, as well as have access to My Chart, an electronic patient access tool that enables patients to communicate with their care team and review medical records online.

Edward Hunsinger, Cigna’s senior medical director for the Carolinas, said in the release that the program’s intent is “to fundamentally change the health care delivery system by rewarding physicians for results.”

“A patient-centered system that’s focused on prevention and wellness, combined with the right incentives for physicians, will ultimately result in a healthier population and lower medical costs. That’s good for individuals, families, employers and doctors,” Hunsinger said.

He said that patients most likely to see the immediate benefits were those who need help managing chronic conditions, such as diabetes or heart disease.

NHRMC gets top hospital recognition

New Hanover Regional Medical Center recently received statewide recognition for excellence, being featured in the Business North Carolina’s March article on the state’s “best hospitals.”

According to the data, NHRMC ranked eighth out of 30 of the state’s top hospitals, along with UNC Hospitals, Wake Forest Baptist Medical Center and Presbyterian Hospital.

NHRMC also ranked eighth in patient picks. The article also stated that Blue Cross and Blue Shield of North Carolina recognized NHRMC as a “cutting-edge hospital” for its bariatrics program and is considered a standout hospital for cardiology and heart surgery, pulmonology, 

gastroenterology and orthopedics.

The rankings were based on data from Medicare and Medicaid, the N.C. Hospital Association and other sources on criteria including patient satisfaction, readmission rates for certain conditions, patient safety records and others.

Blue Cross and Blue Shield of North Carolina recognized hospitals based on quality and expertise in the delivery of surgical procedures. It combines objective data from multiple sources, including the insurer’s experience and collaboration with physicians and professional organizations, hospital officials said.

Lung cancer screenings available at NHRMC

NHRMC is offering screenings for patients with a history of cigarette smoking or exposure to lung cancer-causing agents that can help detect lung cancer in its early stages.

Hospital officials said the Lung Computed Tomography (CT) Screening is a quick, painless test in which patients experience only slightly more radiation than they would get from a traditional X-ray.

The screening is available at two NHRMC Health & Diagnostics locations: NHRMC’s Cape Fear campus on Wrightsville Avenue and the NHRMC Health & Diagnostics location on Military Cutoff Road.

Insurance plans do not currently cover the cost of Lung CT Screening. and the fee is $180.

Anyone who has completed the smoking cessation class offered by NHRMC receives a discount for the lung screening. Participants in the lung screening qualify for a discount to the smoking cessation class.

For more information on the lung screening, call 262-0330. For more information on NHRMC’s smoking cessation course, call 452-8297.