Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Archive
    • Podcast: NC Health Policy Forum
    • Upcoming Scientific Articles
  • Info for
    • Authors
    • Reviewers
    • Advertisers
    • Subscribers
  • About Us
    • About the North Carolina Medical Journal
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Help
    • RSS
  • Other Publications
    • North Carolina Medical Journal

User menu

  • My alerts
  • Log in

Search

  • Advanced search
North Carolina Medical Journal
  • Other Publications
    • North Carolina Medical Journal
  • My alerts
  • Log in
North Carolina Medical Journal

Advanced Search

  • Home
  • Content
    • Current
    • Archive
    • Podcast: NC Health Policy Forum
    • Upcoming Scientific Articles
  • Info for
    • Authors
    • Reviewers
    • Advertisers
    • Subscribers
  • About Us
    • About the North Carolina Medical Journal
    • Editorial Board
  • More
    • Alerts
    • Feedback
    • Help
    • RSS
  • Follow ncmj on Twitter
  • Visit ncmj on Facebook
LetterPolicy Forum

Downward Trends in Medicaid Costs

Let's Recognize What's Been Working!

C. Annette DuBard
North Carolina Medical Journal March 2017, 78 (2) 140; DOI: https://doi.org/10.18043/ncm.78.2.140
C. Annette DuBard
former chief health information officer, Community Care of North Carolina, Raleigh, North Carolina
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: annettedubard@gmail.com
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

To the Editor—In the January/February issue of the NCMJ, Sutten and Borchik provide an excellent overview of trends in Medicaid enrollment and expenditures. Figure 4 of that article reveals a steady decline in per beneficiary cost since 2009, most steeply and consistently since 2012. The authors acknowledge “increased pharmaceutical rebates, hospital claims reprocessing, and the end of enhanced physician payments through the Affordable Care Act” [1] as contributing factors, but fail to acknowledge a major driver of cost savings: North Carolina's remarkable success in reducing hospital use by Medicaid beneficiaries.

Statewide, the 1.6 million Medicaid beneficiaries enrolled in North Carolina's current managed care system—Community Care of North Carolina—are experiencing hospital admission rates 26% lower than in 2012, after accounting for fluctuations in the case mix of the enrolled population over time. Admission rates are 32% lower among children and 23% lower among adults (see Figure 1). This amounts to 21,595 fewer hospitalizations in 2016 than would have been expected based on 2012 rates.

FIGURE 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
FIGURE 1.

Inpatient Admissions per 1,000 Member Months

North Carolina's success in reducing hospitalizations for Medicaid beneficiaries has received national acclaim, and is a testimony to the collective contributions of 1,860 primary care practices who provide medical homes for Medicaid beneficiaries; our robust, statewide, community-based, multidisciplinary care management infrastructure; our innovative community partnerships that coordinate care services for complex patients; our hospitals who have actively engaged in real-time data sharing to improve care transitions; and our sophisticated advances in data analytic strategies to assure that services are targeted toward those patients who are most likely to benefit.

As North Carolina looks forward to new opportunities for advancing population health and value-based care under Medicaid reform, we can be proud of the success record we are building upon. While risk-bearing contracts in most states and most markets aim to slow the growth of per capita health care costs, we have already been reducing health care costs in North Carolina Medicaid, steadily, for years. Let's acknowledge that! Let's recognize that we have done this in the absence of financial incentives for corporations or providers, but rather through the contributions of countless North Carolinians who care first about quality, patient experience, and the health of our most vulnerable citizens. And let's see what more we can do from here, together.

Acknowledgments

Potential conflicts of interest. C.A.D. has no relevant conflicts of interest.

  • ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

References

  1. ↵
    1. Sutten T,
    2. Borchik R
    An overview of North Carolina Medicaid and Health Choice. N C Med J. 2017;78(1):58-62.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

North Carolina Medical Journal: 78 (2)
North Carolina Medical Journal
Vol. 78, Issue 2
March-April 2017
  • Table of Contents
  • Index by author
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on North Carolina Medical Journal.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Downward Trends in Medicaid Costs
(Your Name) has sent you a message from North Carolina Medical Journal
(Your Name) thought you would like to see the North Carolina Medical Journal web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
11 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Downward Trends in Medicaid Costs
C. Annette DuBard
North Carolina Medical Journal Mar 2017, 78 (2) 140; DOI: 10.18043/ncm.78.2.140

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Downward Trends in Medicaid Costs
C. Annette DuBard
North Carolina Medical Journal Mar 2017, 78 (2) 140; DOI: 10.18043/ncm.78.2.140
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Acknowledgments
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

Policy Forum

  • Health Policy Gets Personal
  • Breaking the Cycle
  • Breaking the Cycle
Show more Policy Forum

CORRESPONDENCE

  • Perinatal Substance Use Care Coordination: The Need for One Care Plan
  • Letters of Correspondence: Telehealth, Post-Acute Sequelae of COVID-19, Lung Cancer Screening RatesTelehealth Has Been Great for Patients. Keep the Phone Visits.COVID-19’s Lasting Impact on North CaroliniansImproving Low Dose Lung Cancer Screening Computerized Tomography Scan (LDCT) Enrollment Rates
  • Raising Awareness of Alzheimer’s Disease and Dementia in Native Americans in North Carolina
Show more CORRESPONDENCE

Similar Articles

About & Contact

  • About the NCMJ
  • Editorial Board
  • Feedback

Info for

  • Advertisers
  • Authors
  • Reviewers
  • Subscribers

Articles & Alerts

  • Archive
  • Current Issue
  • Get Alerts
  • Upcoming Articles

Additional Content

  • Current NCIOM Task Forces
  • NC Health Data & Resources
  • NCIOM Blog
North Carolina Medical Journal

ISSN: 0029-2559

© 2022 North Carolina Medical Journal

Powered by HighWire