I recently had the opportunity to interview Dave Richard, the Executive Director at The Arc of North Carolina. It was a very insighful conversation as Dave was able to elaborate on his agency's experience with North Carolina's transition away to Managed Care Organizations (MCOs). The MCO model is gaining steam in states across the country because, for the states, the management of medicaid waiver services gets outsourced to private insurance (MCO). The state not only saves money by not having to administer the funds they also typically set up a supports budget per participant based on needs assessments that come out to be, on average, cheaper per person than the old way. This capitated model is appealing to state legislatures because it reduces state medicaid expenses helping the state government get to a balanced budget. While this model seems great from a state government perspective, it is less than appealing to providers of i/dd services for a variety of reasons. Dave talked about these reasons, as well as the importance of having electronic records during an MCO transition. Below is an exerpt from the interview.
