If CCNC Saves NC Medicaid So Much $$, Why is NC Medicaid So Expensive?

In a report published this week by the Office of State Auditor, Community Care of North Carolina (CCNC) was found to have saved the state’s Medicaid program millions of dollars.    

During a 10-year period between 2003 and 2012, Community Care of North Carolina, or CCNC, helped keep patients out of the hospital and saved about $78 per user per quarter, according to the report. That analysis comes as CCNC’s future as a state contractor is in question because lawmakers are getting ready to remake the health insurance system that cares for 1.8 million poor and disabled residents.

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Community Care of North Carolina helps coordinate the care all of those providers are giving to patients. The company helps ensure that patients keep their appointments, take their medications and aren’t given conflicting treatment plans by different doctors.

In essence, CCNC is providing something akin to managed care to 1.4 million patients, or roughly 14 percent of North Carolina’s population.

CCNC is fighting to remain a key player in the ongoing debate over how to reform NC’s Medicaid program.

Past reports have credited CCNC with significant savings, but many difficult questions remain unanswered about the true value of CCNC.

Some critics have slammed the reports claiming that CCNC saves Medicaid billions of dollars, saying the reports ignore the overwhelming amount of data that contradicts their claims.

Indeed, this 2012 Civitas article called out CCNC’s effectiveness with some tough questions:

If CCNC is producing such significant cost savings for Medicaid expenses, why are key categories of Medicaid expenses so much higher here than for North Carolina’s Southeastern neighbors? The group with the highest rate of CCNC enrollment is children, yet North Carolina’s average Medicaid expenditure for children is 15^th highest in the nation and a whopping 27 percent higher than the average of our Southeastern neighbors. Furthermore, the other eligibility group to have CCNC oversight the longest is the adult population, of which North Carolina’s Medicaid expenses are 12^th highest in the nation and 16 percent higher than regional states.