We understand lawmakers sometimes succumb to the urge to fix what's not broken. But when they, and the voters, see mayhem coming, they usually back away.
We hope that's happening this week, as members of the General Assembly get more evidence that our Medicaid management model is anything but broken.
According to just-released long-term review by the State Auditor's office, the agency that administers the Medicaid program here is saving taxpayers a bundle - and providing improved medical outcomes at the same time.
The audit measured results achieved by Community Care of North Carolina from 2003 through 2012. The physician-led program has won national acclaim for its effectiveness in running the health-insurance program for the poor and disabled. Other states are copying the system, which has produced budget surpluses for the past two fiscal years.
Medicaid, funded jointly by the state and federal governments, covers about 1.4 million North Carolina residents. According to the audit, Community Care succeeded in managing medical conditions and keeping patients out of the hospital. That resulted in savings of about $78 per user per quarter, which adds up to saving state and federal taxpayers something approaching half a billion dollars a year.
Most lawmakers would likely agree that we're talking real money there, yet the drive for privatization still has its hooks in the Senate, our legislative branch most driven by ideologues.
But even there, members have some sense of what's practical, and that became clear earlier this week when the House voted down the Senate's "Medicaid transformation" bill.
House and Senate negotiators are moving toward what they call a hybrid insurance model for Medicaid that would include large managed-care companies and "provider-led entities" created by hospitals or groups of physicians. The care model would shift from paying a fee for each medical service to getting a flat fee per patient and a big incentive to keep those patients healthy.
That new way of doing business is happening across the country in public and private plans. The question is, why does North Carolina need to dismantle the administrative setup it already has? It may be time to change the model of care, but the audit tells us we've already got the right administration in place. If it's not broken, stop fixing it.
