January 5, 2015

A UNC study adds more doubt on the quality of care for Medicaid patients delivered under the current N. C. Department of Health and Human Services /Community Care of North Carolina model.

The study says breast cancer survivors on Medicaid are less likely to receive endocrine therapy followup than other patients. Endocrine therapy can reduce cancer recurrence by 40%. Without it, breast cancer can return elsewhere. The study found “Results suggest substantial underutilization of ET in this population .”

Underuse of life saving drugs doesn’t sound like quality care for Medicaid patients.

Currently, Medicaid is run by NCDHHS bureaucrats and Community Care NC, a $200 million, taxpayer funded nonprofit that coordinates Medicaid care. Basically, CCNC is run or influenced by Medicaid providers who make money off Medicaid.

Making money off Medicaid is the right phrase. A 2013 audit revealed bloated administrative costs and budget overspending of $5 billion in four years.

Conservative reform minded Senators want CCNC to bid against commercial insurance companies to manage Medicaid. Since the audit showed CCNC hasn’t lived up to claims of cost savings, opponents of competition say insurance companies competing with CCNC will hurt the quality of care.

But the UNC study already identified quality problems with Medicaid cancer care under CCNC . And research showed patient satisfaction increased when Medicaid once used managed care in Mecklenburg County.

Republicans in the House ought to live up to their free market principles and embrace competition to fix Medicaid.