- The Child Health Accountable Care Collaborative is the result of a 3-year award from the Centers for Medicare and Medicaid Innovations Center (CMMI), beginning in July 2012. The collaborative, which will provide enhanced care coordination to children with complex chronic illnesses served through the Medicaid and CHIP program, is estimated to save just over $24 million dollars over the 3 year period through reduced emergency room visits, unnecessary hospitalizations and duplicative services. Funds from CMMI will be used to embed pediatric care managers in hospitals and specialty clinics to coordinate care between primary care providers and pediatric specialists. It is not yet explicit how payments linked to value and performance metrics will be incorporated into the collaborative.
- The Dual-Eligible Initiative in North Carolina proposes to expand the current per member per month payments to primary care providers and CCNC Networks towards accountable care activity. The proposal to CMS plans to use Medicaid aged, blind and disabled (ABD) per member per month payments to fund participating primary care providers and CCNC Networks care of dual eligible patients. Providers are incentivized to meet performance metrics, improve care and decrease cost through the use of retrospective performance payments; a specified portion of these payments can only be earned by providers if they meet these defined performance and cost targets.
https://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.png 0 0 NASHP https://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.png NASHP2012-08-21 20:45:512012-08-21 20:45:51North Carolina
In 2010, North Carolina passed Session Law 2010-31, appropriations legislation that, among other things, mandated by July 1, 2012 the Department of Health and Human Services, the Division of Medical Assistance and the North Carolina Community Care Networks (NCCCN) create a comprehensive plan under Community Care of North Carolina (CCNC) that incorporates performance metrics with accountable budget and shared savings payment models. Although no comprehensive plan has currently been released, accountable care is currently being discussed by CCNC as a way to further improve health care for North Carolina’s Medicaid beneficiaries.
CCNC consists of 14 non-profit regional networks that serve over 1 million patients. Providers, practices, hospitals, care managers and community resources coordinate primary care and case management for patients through the medical home model of care delivery. These networks primarily serve the Medicaid population but currently, thanks to many pilot projects, are expanding to serve state employees, Medicare beneficiaries and dual-eligibles.
CCNC pilot projects related to accountable care activity:
Last updated November 2013.
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