Back when the legislature came to town, State Senator Ralph Hise announced Medicaid spending was out of control but he had a solution – Capitation – which worked like this: He was going to hire MCOs (Medicaid HMOs) to run Medicaid then he was going to tell them: This is all you get to spend. Not one penny more.

Hise also announced he was going to shut down Community Care of North Carolina (the non-profit network of doctors who care for over a million Medicaid patients) because, he said, it cost the state money.

But, then, the State Auditor reported she’d done an audit that showed he was wrong, that Community Care saved taxpayers $300 million.

Undeterred, Hise plowed ahead. So here’s ‘The Capitator’s’ plan (provided the House and Governor go along):

1) Community Care closes.
2) State Medicaid spending goes up $300 million over the following year.
3) Hise ‘capitates’ with MCOs.
4) And the MCOs get the $300 million.

So, in the name of cutting Medicaid spending, Medicaid spending goes up $300 million. And that’s ‘capitation.’