New Medicaid system can help NC's pandemic recovery

North Carolina has a new model for administering Medicaid – Medicaid Managed Care – which could help the state recover from the COVID-19 pandemic. According to Assessing the Impact of COVID -19 on Low-Income Households and Communities in North Carolina, research from the North Carolina Community Action Association (NCCAA), the COVID-19 pandemic disproportionately affected low-income families and individuals.

“Low-income people have had their trials multiplied by the pandemic,” said NCCAA Executive Director Sharon C. Goodson. “We heard directly from those hardest hit by COVID-19 of the tremendously heightened financial and health challenges that they are still working to overcome.”

North Carolina’s recent shift to Managed Care earlier this year may help better address Medicaid beneficiaries’ health needs and provide support as North Carolinians recover from the pandemic’s impacts. The Managed Care system has the potential to deliver better health outcomes for Medicaid beneficiaries in part because it addresses social determinants of health and focuses on whole-person care instead of addressing individual health concerns on an as-needed basis. For example, rather than simply providing medical treatment for a child with a respiratory infection, Managed Care helps address whether there are environmental factors in the home that exacerbate the condition, screen for asthma, and provide nutritional guidance to boost the child’s overall health and immune system.

One of the key takeaways from NCCAA’s research was that the pandemic “created major employment challenges and forced low-income households to make difficult decisions and choices regarding work versus personal safety and the health and wellbeing of their families.” COVID-19, like many other illnesses, has shown to have long-term health effects. Managed Care allows beneficiaries to plan for the future and take control of their health through coordinated care services. With the new system, families can work with their health teams to ensure they have the resources they need to continue living healthier lives and continue showing up to work.

The report shows “pandemic-induced layoffs combined with caregiver responsibilities and personal health challenges have decimated the workforce,” meaning that people have reduced financial resources for health care at exactly the time they most need access to that care. With a widespread labor shortage and persistent supply chain crisis, the need for a healthy workforce has never been greater for both employers and employees. Simply stated, healthy employees mean a healthy economy. Managed Care can help North Carolinians address all of their health needs and continue to clock in, while still taking care of their families.

Another key takeaway from the research is that "nonprofit organizations were instrumental in creating a therapeutic community for the most vulnerable families, providing much needed support—financial and socio-emotional as well as basic-necessities, such as food—during the pandemic.” It’s clear that social factors like nutrition, personal safety and access to reliable transportation affect health, and that’s why Managed Care’s whole-person health approach and partnerships with community organizations is so vital. It’s hard to be healthy if you’re not meeting your basic nutritional needs and all the doctor visits in the world can’t keep someone healthy if they go home to an unhealthy living situation. The Managed Care system addresses this by prioritizing comprehensive services that address both clinical and social needs.

Members of North Carolina for Better Medicaid (NCBM), a statewide coalition of health advocates working to support the transition, are seeing the benefits of Managed Care across the state, as beneficiaries from Murphy to Manteo gain access to a wider range of medical and social services. The coalition represents a wide array of stakeholders from across the state, including community advocacy groups, religious organizations, patient advocates, health care leaders and health plans, who believe Medicaid Managed Care is the best way to improve access, quality, outcomes and affordability in North Carolina.

As families across the state work to recover from the many impacts of the COVID-19 pandemic, the state’s new Medicaid Managed Care system will be there to support those hardest hit.

For more information on Managed Care or how to join NCBM in supporting a better Medicaid system, visit NorthCarolinaforBetterMedicaid.org.