Old-Fashioned

Four separate reports – two done for the State Medicaid Department, one done for federal Medicare, and one by the non-profit Community Care of North Carolina filed with State Medicaid – all said CCNC saved taxpayers millions of dollars by reducing Medicaid costs.

So what did the Old Bull Mooses in the Senate do?

They passed a bill to shut down CCNC.

One night, not long ago, an old friend down in Stanly County, near where Allen Dobson practices medicine, called and said Dr. Dobson – who has led ‘Community Care’ for years – was having a hard time understanding politicians. Since then, working alongside Allen, I’ve read more charts and graphs about Medicaid spending than any one person on earth should ever have to bear.

When you boiled away all the statistics, it turned out, Allen had a pretty simple idea: CCNC provided Medicaid patients with a ‘Medical Home’ that worked a lot like an old fashioned family doctor and how those doctors saved money was old fashioned too: They figured an ounce of prevention was worth a pound of cure.

If a Medicaid patient had high blood pressure and ended up in the ER with a stroke followed by a long hospital stay the bills added up – the patient could save himself a lot of heartbreak and the state a lot of money by taking $10 a month in blood pressure pills instead.

And that’s what CCNC’s Medical Homes do: They get people with heart disease, high blood pressure, diabetes and a litany of other ailments, doctors and treatments to keep their illnesses under control to keep them out of the ER.

The sickest Medicaid patients – the Aged Blind and Disabled – who do not have a CCNC doctor (or Medical Home) cost the state $1017 each month (in fiscal year 2013-2014).

The same Aged Blind and Disabled patients who do have a CCNC Medical Home cost the state $882 a month – $135 less per month. Or $1,620 less a year.

Among less sick Medicaid patients, people who have a CCNC Medical Home cost $145 per month while those who don’t cost twice as much ($297 per month) – and since there’re 1.6 million Medicaid patients with CCNC Medical Homes, as the studies all showed, savings add up.

So why would the Old Bull Mooses want to shut down an organization that saves taxpayers money?

Well, that’s where politics – and maybe a touch of irrationality – comes in: The Bull Mooses have fallen head over heels in love with for profit MCOs – which work like Medicaid HMOs – taking over and running Medicaid.

But this is looking like an expensive love affair.

For starters, the Old Bull Mooses have appropriated $350 million to pay for the transition to bring their new MCO friends to North Carolina.

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Carter Wrenn

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Old-Fashioned

Four separate reports – two done for the State Medicaid Department, one done for federal Medicare, and one by the non-profit Community Care of North Carolina filed with State Medicaid – all said CCNC saved taxpayers millions of dollars by reducing Medicaid costs.

So what did the Old Bull Mooses in the Senate do?

They passed a bill to shut down CCNC.

One night, not long ago, an old friend down in Stanly County, near where Allen Dobson practices medicine, called and said Dr. Dobson – who has led ‘Community Care’ for years – was having a hard time understanding politicians. Since then, working alongside Allen, I’ve read more charts and graphs about Medicaid spending than any one person on earth should ever have to bear.

When you boiled away all the statistics, it turned out, Allen had a pretty simple idea: CCNC provided Medicaid patients with a ‘Medical Home’ that worked a lot like an old fashioned family doctor and how those doctors saved money was old fashioned too: They figured an ounce of prevention was worth a pound of cure.

If a Medicaid patient had high blood pressure and ended up in the ER with a stroke followed by a long hospital stay the bills added up – the patient could save himself a lot of heartbreak and the state a lot of money by taking $10 a month in blood pressure pills instead.

And that’s what CCNC’s Medical Homes do: They get people with heart disease, high blood pressure, diabetes and a litany of other ailments, doctors and treatments to keep their illnesses under control to keep them out of the ER.

The sickest Medicaid patients – the Aged Blind and Disabled – who do not have a CCNC doctor (or Medical Home) cost the state $1017 each month (in fiscal year 2013-2014).

The same Aged Blind and Disabled patients who do have a CCNC Medical Home cost the state $882 a month – $135 less per month. Or $1,620 less a year.

Among less sick Medicaid patients, people who have a CCNC Medical Home cost $145 per month while those who don’t cost twice as much ($297 per month) – and since there’re 1.6 million Medicaid patients with CCNC Medical Homes, as the studies all showed, savings add up.

So why would the Old Bull Mooses want to shut down an organization that saves taxpayers money?

Well, that’s where politics – and maybe a touch of irrationality – comes in: The Bull Mooses have fallen head over heels in love with for profit MCOs – which work like Medicaid HMOs – taking over and running Medicaid.

But this is looking like an expensive love affair.

For starters, the Old Bull Mooses have appropriated $350 million to pay for the transition to bring their new MCO friends to North Carolina.

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Carter Wrenn

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Archives