One of the largest healthcare programs provided by the federal government, Medicaid, is transitioning from a fee-for-service model to a value-based model of managed care. The Department of Health and Human Services (HHS) provided individual states the freedom, via waivers, to experiment and design new ways of delivering value-based care for Medicaid beneficiaries. As an early adopter of a value-based managed care model, North Carolina is establishing a Medicaid system that has the potential to both restrain costs and improve the quality of care delivered to beneficiaries.
To prepare the transition to a value-based managed care model, states like North Carolina have focused their efforts around successfully executing on:
Read our report to learn how to plan a successful transition to managed care that includes consideration for Advanced Medical Home (AMH) programs, social determinants of health, and data interoperability and exchange.