To evaluate the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices that contract with NC Medicaid, the North Carolina Provider Experience Survey was developed and administered across all North Carolina primary care practices or their corporate parent.
This report describes findings from the baseline assessment (Year 1) of the provider experience and satisfaction with the traditional NC Medicaid Direct system, including the partnership with Community Care of North Carolina.
Survey responses were collected between May and September 2021. This assessment also explored the experience of providers in early contracting with prepaid health plans (PHPs), as it overlapped with the launch of Standard Plans on July 1, 2021. The baseline assessment will serve as a comparison against PHP performance in future years.
Stratified analyses were conducted to draw comparisons between rural versus non-rural provider groups, small/medium versus large provider groups, and groups delivering obstetrics and gynecology.
The survey was implemented by the Sheps Center for Health Services Research. The full report and a two-page summary are available.
Key Findings
Satisfaction with prior Medicaid program (NC Medicaid Direct), including CCNC/Carolina Access
- Systems and practices were generally satisfied with North Carolina’s pre-existing Medicaid program. Organizations expressed the greatest satisfaction with claims processing (79% rated as excellent/good) and overall provider relations (74% rated excellent/good).
- Organizations were least satisfied with access to behavioral health services for Medicaid patients and the process for managing grievances and appeals. Only 36% of respondents rated access to behavioral health therapists as excellent/good.
- Rural practices rated their experience with the prior NC Medicaid system slightly less favorably in the areas of adequacy of reimbursement, access to needed drugs and support for addressing social determinants of health (SDOH).
Experience contracting with PHPs
- When asked how important items were when deciding to contract with PHPs, respondents prioritized claims and reimbursement as well as access to specialists and behavioral health care for patients.
- Among independent groups and medical practices, administrative items were rated more important for contracting with PHPs than support for quality and population health (e.g., case management, coaching, data sharing, SDOH support).
- 70% of organizations rated their satisfaction interacting with PHPs thus far as excellent or good.
For more information, please visit the NC Medicaid Quality Management and Improvement webpage.
Contact
NC Medicaid Contact Center: 888-245-0179