North Carolina Primary Care Payment Reform Task Force Report
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On April 17, 2024, the North Carolina Primary Care Payment Reform Task Force released it’s report to the Joint Legislative Oversight Committee on Health and Human Services and Joint Legislative Oversight Committee on Medicaid.
The overarching goal of this effort was to generate recommendations to increase the amount of expenditures that North Carolina payors (insurance companies, prepaid health plans, etc.) devote to promoting and providing primary care (aka “care aimed at prevention, wellness, and treatment for common illnesses” via CMS).
In an update to the WNC Health Policy Initiative on April 12, 2024, Task Force member Dr. Mark McNeill noted that “National data demonstrates increased investment in primary care is correlated with better performance on quality and patient measures, lower hospital and ER use, and lower total cost of care.”
Senate Bill 595 to establish the North Carolina Primary Care Payment Reform Task Force, sponsored by (WNC HPI Expert in Residence) Senator Ralph Hise and Senator Jim Burgin, was submitted to the NC General Assembly on April 6, 2023.
Unfortunately, the formation and work of the Task Force was pushed back by the 2023-2024 NC budget delays, but 5 meetings (open to the public) were held over January and February of 2024, culminating in this report (originally due April 1).
The report offers a definition of “primary care,” and outlines the following recommendation on setting primary care investment targets, developing a primary care data collection strategy, assessing primary care workforce and outlines recommended ongoing work and future activities of the Task Force.
Members of the Task Force include:
Jay Ludlam (Deputy Secretary for Medicaid)
Robert Croom (Sr. Deputy Commissioner for the NC Dept. of Insurance)
Sam Watts (Administrator of the NC State Health Plan)
Hugh Tilson (Director of NC AHEC)
Christie Burris (Chief Data Officer and Director, Government Data Analytics Center, N.C. Department of Information Technology)
Dr. Mark McNeill (President-Elect and representative of the NC Academy of Family Physicians)
Michelle Schmerge, DNP (Co-Founder & CEO of Equity Health, representative of the NC Nurses Assoc.)
Dr. Larry Wu (Medical Director for Blue Cross Blue Shield NC, representative of NC Assoc. of Health Plans)
Dr. Genie Komives (Chief Medical Officer at WellCare of North Carolina, representative of Pre-Paid Health Plans)
Cody McKinney (CFO at WNC Community Health Services, Representative of NC Community Health Center Association)
