Focus Area: Healthcare Access & Equity

Overview

The things that make Western North Carolina special - the sweeping mountain vistas, vibrant mountain culture and towns, and strongly-held attitudes of independence and self-sufficiency within its communities - can also be the source of some of its greatest challenges. Patients and care providers in WNC experience barriers to receiving and administering care that are unique and complex due to the rurality of the region's physical (and cultural) landscape. Whether it’s navigating the sometimes treacherous mountainous terrain, the critical gaps in healthcare, public and other infrastructure, or the cautious attitudes of those who have often felt left out of the conversations about their health and wellbeing happening “down the mountain,” these barriers require a combination of creative problem-solving, iterative innovation, and broad collaborative effort to overcome them - luckily, all things that the people and communities of the WNC region excel at.

A key focus area for the HPI is coordinating efforts to establish synergistic working relationships between interested parties across the region in key priority areas — such as rural primary health, Medicaid expansion and transformation, maternal and child health, mental health, substance use disorders, and other similar issues. This work is vitally important for understanding WNC’s challenges, as well as for identifying solutions and opportunities for growth and improvement as we work toward the goal of providing of equitable, affordable, and quality healthcare access to all Western North Carolinians

HA&E WORK GROUPS AND PRIORITIES

Medicaid Expansion Impacts

Although the recent passage of Medicaid expansion in North Carolina marked a significant milestone in expanding healthcare access in NC, its implementation comes with equally significant challenges, including:

  • Ensuring an effective, efficient and policy-compliant statewide rollout at all relevant government, provider, health plan, and other healthcare infrastructure levels

  • Accurate and timely determination of patient eligibility and beneficiary enrollment or re-enrollment, including a full-roster eligibility redetermination of all current Medicaid beneficiaries due to the concurrent unwinding of COVID-pandemic-related eligibility protections

  • Mounting and maintaining an effective public awareness outreach campaign to inform potential beneficiaries of their options

  • Ensuring and maintaining adequate provider access

  • Minimizing administrative burden on providers and ensuring accurate reimbursement for services rendered

  • …and many others

Delays in or disruptions to these efforts can mean eligible residents might not get needed access to care or might have that care delayed, and that health systems and providers might not be properly reimbursed for providing that care.

Since NC’s expansion involves adding an estimated 600,000 newly-eligible and expanded-services-eligible individuals to rolls, moving into this new era of expanded healthcare access represents a massive undertaking to ensure that our healthcare infrastructure is not strained past the point of breaking. Our HA&E work group is currently focused on addressing this issue and those related to healthcare workforce sustainability through the lens of increasing provider participation and workforce expansion to help meet the expanding need.

2024-2025 Priorities and Objectives

Short-Term – Increase provider participation including mental health providers, specialists, and primary care:

  • Compile and monitor Medicaid data (focused on billing complexity and provider adequacy) to create strategies and investments to grow and maintain the workforce.

  • Share what is learned about what data is currently being tracked around Medicaid providers/billing, and other pertinent data points, as well as create data-driven recommendations for action items that WNC HPI can undertake.

  • Create the most up to date maps of Medicaid provider information to inform conversations about gaps in coverage with policy makers and other stakeholders.

Longer-Term – Expand capacity of physical health and behavioral health workforce