This is the final report of the NCIOM Health Reform Workgroups. The groups met from 2010-2012 and included more than 250 members from across the state. The workgroups issued recommendations in eight areas impacted by the Patient Protection and Affordable Care Act including:Health Benefit Exchange, Medicaid, Safety Net, Health Professional Workforce, Prevention, Quality, New Models of Care, and Fraud, Abuse, and Overutilization.
The Affordable Care Act (ACA) is arguably the most comprehensive health legislation ever enacted. The Secretary of the United States Department of Health and Human Services has responsibility to oversee the implementation of many of the provisions of the ACA. However, states, health care professionals, and businesses have responsibility to implement other sections of the law. The ACA offers the potential to improve health care access, quality, and population health, while reducing escalating health care costs, but it creates new challenges for the state, families, businesses, health care professionals, and organizations. In order to implement the new law, the North Carolina Department of Insurance (NCDOI) and the North Carolina Department of Health and Human Services (NCDHHS) asked the North Carolina Institute of Medicine (NCIOM) to convene workgroups to examine the new law and gather stakeholder input to ensure that the decisions the state makes in implementing the ACA serve the best interest of the state as a whole.
An Overall Advisory Committee helped to coordinate the work of eight separate workgroups that focused on different sections of the ACA: Medicaid; Health Benefit Exchange and Insurance Oversight; Health Professional Workforce; Prevention; Quality; New Models of Care; Safety Net; and Fraud, Abuse, and Overutilization. These workgroups were charged with studying specific areas of the ACA and providing advice to the state about the best way to implement these provisions. Altogether, 260 people from across the state are members or steering committee members of the Advisory Committee or one or more of the eight workgroups.
The Health Reform Workgroups previously issued two interim reports: Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina: Draft Final Report Pending U.S. Supreme Court Decision (2012) and Implementation of the Patient Protection and Affordable Care Act in North Carolina (2011)
Financial support for this effort has been provided by generous grants from Kate B. Reynolds Charitable Trust, Blue Cross and Blue Shield of North Carolina Foundation, The Duke Endowment, John Rex Endowment, Cone Health Foundation, and the Reidsville Area Foundation.
- Medicaid Expansion Option Issue Brief
- Full Report
- Executive Summary
- Chapter 1: Introduction
- Chapter 2: Health Benefit Exchange
- Chapter 3: Medicaid
- Chapter 4: Safety Net
- Chapter 5: Health Professional Workforce
- Chapter 6: Prevention
- Chapter 7: Quality
- Chapter 8: New Models of Care
- Chapter 9: Fraud and Abuse
- Chapter 10: Conclusion
- Appendix A: Workgroup Members
- Appendix B: Data on Uninsured in North Carolina
- Appendix C: Medicaid Cost Estimates
- Appendix D: REMI Cost Analysis
- Appendix E: Safety Net Oragnizations in North Carolina
- Appendix F: Transitions of Care Subcommittee Findings
- Appendix G: New Models of Care Principles
- Appendix H: New Models of Care in North Carolina
- Appendix I: ACA Funding in North Carolina
- Presentation: ACA Medicaid Expansion Option
- Presentation: Impact of the Affordable Care Act on North Carolina