Progress on Transforming Medicaid

Submitted by Lee Dobson, Area Director, Government Affairs (GAO)

Ten months into her new job Secretary of Health & Human Services, Dr. Mandy Cohen has been working to move her Medicaid Transformation plan forward. She hired an implementation guru from Missouri, Jay Ludlam as the Assistant Secretary for Medicaid Transformation to lead the process. Medicaid’s hope is to address the physical and behavioral health of North Carolinians. The goal is to improve overall health by creating an innovative and well-coordinated Managed Care environment that addressed the whole-person. The program design calls for three state-wide commercial plans and up to twelve provider-led entities (PLE) as regional plans.  The department’s aggressive timeline will release request for proposals (RFP) in early 2018, with a targeted transition in 2019, pending CMS approval.  BAYADA has been invited to participate in stakeholder discussions as Medicaid develops their Pre-paid Health Plan (PHP) model. Our goal, related to home care, is to ensure level of services and provider adequacy remains central in the program design and waiver application. GAO has involved technical experts from across our various practices to ensure our feedback is sound and supports BAYADA’s overall mission.

“649 Days Until Medicaid Managed Care Go-live” – Will Medicaid Meet Its Goal in NC?

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

 Last week, I attended the Medical Care Advisory Council (MCAC) meeting where Jay Ludlam the new NC Department of Health and Human Services (DHHS) Assistant Secretary for Medicaid Transformation presented the department’s program design for taking Medicaid into a managed care environment.  Having been on the job for less than three weeks, Ludlam said, “649 days until the Medicaid Managed Care go live date!”  While many steps need to occur before “go live”, including formal approval by Centers for Medicare and Medicaid Services (CMS), the department is aggressively working towards that goal.  I spoke with Mr. Ludlam after the meeting, not only to introduce BAYADA but also to express our concerns with the fast pace, and lack of details for how long-term services and supports will be incorporated into reform.  As you may recall, BAYADA formed a review team and has already submitted comments to the program design. The Government Affairs Office (GAO) will continue to participate in the discussion as the state formulates its plan.  Click to read Jay Ludlam’s complete bio.

Photo of Jay Ludlam link to his bio
Photo of Jay Ludlam link to his bio