Starting July 1, nearly 1.6 million Medicaid beneficiaries in North Carolina will begin receiving the same Medicaid services in a new way through NC Medicaid Managed Care health plans (see the NCDHHS press release). Most beneficiaries will continue to get care from the same doctors they see today but will now be a member of a health plan. Some beneficiaries will not enroll with health plans and will remain in NC Medicaid Direct.
The launch of NC Medicaid Managed Care Standard Plans and EBCI Tribal Option is a significant milestone as NCDHHS continues to build an innovative health care system that puts the health of beneficiaries at the forefront. Features of the managed care program include establishing a payment structure that rewards better health outcomes, integrating physical and behavioral health, and investing in non-medical interventions aimed at reducing costs and improving the health of Medicaid beneficiaries. Our goal for Day One of NC Medicaid Managed Care is that people get the care they need and providers get paid.
The following resources are available to help you and your Medicaid patients with the transition to managed care:
- The Provider Day One Quick Reference Guide and Fact Sheet are available on the Fact Sheet webpage.
- What Beneficiaries Need to Know on Day One fact sheet – English | Spanish
You are also encouraged to visit the Provider Playbook on the NC Medicaid website. Additionally, the NC Medicaid Help Center is where you can find answers, ask a question or submit a concern.
More information on NC Medicaid Managed Care can be found on the NC Medicaid Transformation webpage.