CHAPTER AFFAIRS By Gregory K. Griggs, MPA, CAE NCAFP Executive Vice President
~ ACADEMY IN ACTION ~
Keep Moving Toward Value, Even with a Pause in N.C. Medicaid Transformation
Carolina are working to use physician-led, team-based care along with technology to provide care closer to where patients live and in a more integrated manner. The bottom line: many people are embracing the promise and value of Family Medicine, but we cannot rest on our laurels. So how do we all continue to work together to capitalize on this potential promise. First and foremost, we don’t stop preparing – for value-based care or Medicaid managed care. Here are just a few steps you can consider taking over the next few months: • Work to bring care management closer to your patients.
While the move to Medicaid managed care in North Carolina has temporarily hit the pause button, the march to value in our state and country continues. And this is a march that can benefit Family Medicine greatly, if we are prepared and harness the opportunity. Today, more than ever, employers, payers and individual patients are all realizing the value that Family Medicine brings to the healthcare system. Blue Cross and Blue Shield of NC is increasing payment to high quality independent primary care practices, holding health systems more accountable for the total cost of care, and partnering with other companies to assist primary care practices in meeting the quadruple aim.
• Embrace technology to provide better care and shift administrative burden from physicians to other team members. • Work to align any value-based incentives you may receive from any of your payers, whether it’s commercial insurance, Medicare Advantage plans or ultimately Medicaid managed care plans. • If you work within a system, advocate for a better environment for Family Medicine. We have one-pagers and other information that can help you show your own system the value of primary care. (See sidebar) • Continue to choose partners that can help enhance the care you deliver.
Medicare, despite the bureaucratic nature of CMS, continues to experiment with ways to put primary care at the center of healthcare, including the Primary Care First Initiative which will be offered in parts of 26 states, even though it won’t yet be available in North Carolina.
• Examine your own referral patterns to see if you are utilizing high-value, low cost specialists when referring most of your patients.
Small and large employers alike are direct contracting with Direct Primary Care practices to provide much needed healthcare to their employers.
•And finally, let the Academy know how we can help advocate for you no matter your practice situation. Today, we have better contacts with payers and health care systems than we have ever had before.
Primary care practice groups right here in North
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• Look for ways to identify care gaps and fill them in an efficient and effective manner.
The North Carolina Family Physician
