June 12, 2015

NCDHHS hasn’t clued the public in on how big this year’s June surprise is going to be in Medicaid.

Almost an annual ritual, the June surprise is the confession time when NCDHHS admits Medicaid overspent the budget and more money is needed.

And this year’s surprise is likely a doozy. Because the News and Observer just reported ”The state Medicaid office owes medical providers nearly two years worth of back payments for poor, elderly patients, an expense that will increase past and future costs, according to the state budget office.

The need to catch up with nearly two years worth of Medicaid expenses runs counter to the state Health and Human Services department’s narrative that it has cleaned up longstanding problems in Medicaid.” (Raleigh News & Observer)

Two years of unpaid medical bills sounds big. In fact, the State Auditor said Medicaid overspent the budget by $1.9 billion in state money between 2009-12,$5 billion state and Federal.

And now it looks like NCDHHS has been claiming surpluses while piling up unpaid medical bills.

Of course, all this chaos plays into the hands of CCNC and other reform opponents. Their new message is Medicaid is a mess that can’t be fixed because it’s hard.

Here are a few suggestions how we might stop the budget busting and end the surprises.

NCDHHS is like a pitcher loading the bases and giving up a grand slam. Yank them.

Make CCNC /ACOs compete with managed care companies to run Medicaid under a fixed price contract with an independent Medicaid administrator supervising . The spin that managed care is bad for quality care is wrong. Washington already imposes quality standards on Medicaid managed care plans and the state contract can raise them if necessary.

Give the Medicaid administrator budget sequester power if spending goes out of control.

Rigorously audit the continued eligibility of recipients. Illinois removed 300,000 ineligible recipients that way. (Beaufort County Now)

Reward patients improving their lifestyle and penalize those who don’t.

Focus on home care instead of nursing home care.

When Apollo 13 was dying in space, failure was not an option at Mission Control. Why accept chronic Medicaid failures now?