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North Carolina Gets ‘Go Ahead’ for Innovative Public-Private Partnership To Improve Health Care in Rural Communities

For release: Immediate    Nov. 17, 2010
Contact: Renee McCoy, 919-733-9190

RALEIGH — North Carolina will receive a federal award of approximately $11.8 million to launch an innovative public-private partnership designed to help the health care system work more efficiently for the people of the state, providing improved health outcomes, lower costs and more communication between insurers and payers.

The N.C. Department of Health and Human Services is collaborating with Community Care of North Carolina Inc., Blue Cross Blue Shield of North Carolina and the State Health Plan for Teachers and State Employees in a three-year Multi-payer Advanced Primary Care Practice Demonstration. The funding for the partnership comes from the federal Center for Medicare and Medicaid Services.

“This is a major step forward in the improvement of quality medical care delivered to patients in rural communities across the state,” said DHHS Secretary Lanier Cansler. “The strength of this initiative is that it could be easily replicated in rural areas across the nation. Many states share our characteristics and are struggling to find a model that works for them.”

The initiative extends the benefits of Community Care networks, which currently serve nearly 1 million North Carolina Medicaid recipients, to some rural citizens whose health coverage is through Medicare, BCBSNC or the State Health Plan. Community Care’s networks of medical practices provide a “medical home” that manages and coordinates an individual’s health care, emphasizing patient education, management of chronic conditions and information technology to track treatments and outcomes.

Community Care’s medical networks, which have achieved national recognition and saved N.C. Medicaid an estimated $1 billion since 2003, were created to address the issue of fragmented, duplicative and uncoordinated care, which can hinder the successful treatment of patients with multiple chronic conditions. The problem is especially acute in rural areas, where patients may travel long distances to see multiple medical providers. Medical providers with rural patient populations can find that tracking and coordinating care are both challenging and costly. Providers enrolled in a Community Care network receive technology and other resources to provide higher-quality, more coordinated care to their Medicaid patients.

The approximately $11.8 million grant from the federal Medicaid and Medicare agency will augment the health care infrastructures of seven rural counties — Ashe, Avery, Bladen, Columbus, Granville, Transylvania and Watauga — so that citizens currently insured by Medicare, Blue Cross or the State Health Plan can enroll in Community Care networks.

“Blue Cross and Blue Shield of North Carolina is pleased to offer our expertise and commitment to this project,” said Dr. Eugenie Komives, senior medical director and vice president of the insurer. “We believe coordinating quality care and services through the medical home model is an important step that will maximize resources and efficiencies for thousands of patients across the state.”

Dr. Jack Walker, executive administrator of the State Health Plan, touted the benefits for members in the demonstration communities. “As a result of this collaboration between Community Care of North Carolina, Blue Cross Blue Shield of North Carolina, DHHS and the State Health Plan, these members will receive a benefit enhancement of care management services with expected improvements in quality, health outcomes and cost trends. The Plan is honored to participate in this landmark initiative and distinction for our state.”

In the seven counties of the demonstration project, Community Care medical homes currently serve 112,774 state Medicaid recipients. Over the three-year life of the project, CCNC benefits will be extended to an estimated 128,186 Medicare recipients and 121,011 privately insured BCBSNC or State Health Plan recipients.