Medicaid Transformation: A Long Time Coming

It's been a long time coming. Medicaid transformation, set in motion in 2015, will soon enough simply be the way North Carolina does Medicaid.

But what a journey: discussion to proposal, draft to legislation, debate, opposition, support, and passage was only the beginning. There was the waiver to consider, more drafts and submissions, advocacy and lobbying, questions and answers, waiting and wondering, balancing health care, health, quality, cost, patient and provider experience, and innovation.

Even after approval: RFIs and RFPs, white papers, consumer and provider engagement, forums, input, timelines, contracts awarded and negotiated, and additional timelines and rollouts.

If the public, providers, or consumers are a little weary or confused it isn't for lack of effort on the part of the state, the prepaid health plans, or advocates who want to see our transformation succeed. Other states, too, are looking to our bold plan not only to deliver health care but to use Medicaid dollars to purchase health by supporting housing, nutrition, family safety, and transportation—all proven investments in better health outcomes.

This issue of the journal asks the health plans to explain in their own words what they have done elsewhere and what they will do here to improve the health care—and health—of Medicaid recipients. We also invited experts to describe results both from pilots and from other states where Medicaid transformation has taken place.

Read on and join us at the North Carolina Institute of Medicine's Annual Meeting, whose topic this year is Medicaid transformation, on Sept. 5, 2019. Visit www.nciom.org for registration details. Let's continue the discussion.

• ©2019 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.