Gov. Perdue and Sen. Hagan Applaud CMS Announcement That More North Carolinians Will Benefit from Patient Centered Medical Homes

Press Release

Gov. Bev Perdue and U.S. Senator Kay Hagan today praised the recent Centers or Medicare and Medicaid Services (CMS) announcement that the North Carolina Community Care Networks was selected to expand patient-centered medical homes. North Carolina was one of only two states selected by CMS to implement a new Medicare quality demonstration to improve the quality of care received by Medicare beneficiaries at less cost to the taxpayer.

Under the community care "medical home" model, each patient has access to a primary care provider who is responsible for overseeing comprehensive and preventative care, working in collaboration with nurses, specialists, and other health care professionals. The primary care provider serves as the nexus for all of a patient's care and medical history.

With this announcement, North Carolina will be able to expand this model of care to more North Carolinians by including those who are simultaneously eligible for both Medicare and Medicaid programs, and well as Medicare-only beneficiaries. Currently, the model is only used for Medicaid patients. Gov. Perdue has been a supporter of expanding the "medical home" model.

"North Carolina is a leader when it comes to the medical home care system that improves quality of care while reducing costs," said Gov. Perdue. "North Carolina's innovative solutions continue to be recognized nationally."

Senate Hagan advocated for the community care model on the Senate floor. "The patient centered medical home, which was pioneered in North Carolina, is an innovate delivery system that improves patient health and saves taxpayer money," Hagan said. "It's great news for North Carolina that CMS has allowed our state to expand this worthwhile program to additional North Carolinians."

For more than ten years, Community Care of North Carolina has successfully brought the patient-centered medical home to Medicaid beneficiaries. And the program has saved the state hundreds of millions of dollars. From 2003 to 2007, the state saved over $500 million. Community Care of North Carolina is comprised of 14 networks that include more than 4,000 physicians in all 100 counties and cover more than 985,000 Medicaid enrollees.

During the first two years of the demonstration, Community Care will manage approximately 30,000 North Carolinians simultaneously eligible for both the Medicare and Medicaid programs who receive their care from physicians in more than 200 Community Care practices in 26 counties. At the beginning of year three, Community Care will extend the program to those only eligible for Medicare.

Those eligible for Medicare and Medicaid and served by Community Care under this demonstration have high medical needs. More than half will have three or more chronic medical conditions and more than one third will also a have mental health condition. To assist these patients in achieving better health outcomes, participating Community Care Networks and practices will work together to:

* Assist patients in their transition from different care settings. 20% of Medicare patients discharged from the hospital are readmitted within 30 days.
* Assist patients with complex medical and social conditions.
* Reduce medication problems.
* Support patients (and families) in the self-management of their diseases.
* Strengthen the link between community providers.
* Enhance physicans' practice's ability to manage patients with chronic conditions.

This demonstration is commonly referred to as the "646 Demonstration." The demonstration is part of a five year Medicare Health Care Quality demonstration mandated by Congress in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Source