North Carolina

North Carolina established one of the first statewide PCMH networks in the country through Community Care of North Carolina (CCNC). CCNC served as an early model for improving health care delivery through a strong model of community-based primary care teams in partnership with public health and both public and private payers of heatlh care. CCNC leaders describe the evolution of the program and key partnerships on their website. Supported through legislation (Session Law 2010-31), CCNC continues to serve as the anchor program in North Carolina for most of its health improvement and cost-containment efforts including Care Coordination for Children (CC4C), Dual-eligible initiative, Multi-payer Advanced Primary Care Practice Project (MAPCP), and Palliative Care Initiative, just to name a few. All of these programs continue to build on the CCNC medical home approach to care. The state's participation in the MAPCP demonstration ended 12/31/2014.

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

Multi-Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Community Care of North Carolina (CCNC) Multi-Payer Statewide ACA Section 2703 Health Homes
Multi-Payer Advanced Primary Care Practice - North Carolina Multi-Payer Statewide

Private Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Aetna Patient-Centered Medical Home (PCMH) - Carolinas HealthCare System Commercial Charlotte Aetna Patient-Centered Medical Home Program
Aetna Patient-Centered Medical Home (PCMH) - Cornerstone Health Care Commercial Central North Carolina Aetna Patient-Centered Medical Home Program
Blue Quality Physician Program Commercial Statewide Blue Cross Blue Shield Value-Based Care Program
Cigna Collaborative Accountable Care Program - Boice-Willis Clinic Commercial Eastern North Carolina Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - CaroMont Medical Group Commercial Gastonia, NC & Bloomfield, CT Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - Cornerstone Health Care Commercial Greensboro and Winston-Salem Cigna Collaborative Care Program
Cigna Collaborative Accountable Care Program - Novant Health Commercial Charlotte, Winston-Salem, Kernersville, Thomasville, Bolivia, Salisbury, Louisburg, Gaffney, SC, Manassas, VA Cigna Collaborative Care Program
Humana medical home program - Caromont Medical Group Commercial Gastonia Humana Medical Home Program
Humana medical home program - Catawba Valley Medical Center Commercial Hickory Humana Medical Home Program
Humana medical home program - Cornerstone Health Care Commercial High Point Humana Medical Home Program
Humana medical home program - Duke University Affiliated Physicians Commercial Durham Humana Medical Home Program
Humana medical home program - Novant Commercial Charlotte Humana Medical Home Program

State Legislation

Legislation Status Year
North Carolina Session Law 2010-31

The legislation supports Community Care of North Carolina (CCNC) to continue serving as the anchor program in North Carolina for most of its health improvement and cost-containment efforts including Care Coordination for Children (CC4C), Dual-eligible initiative, Multi-payer Advanced Primary Care Practice Project (MAPCP), and Palliative Care Initiative, just to name a few.

Enacted 2010
S 595

S 595 would establish a Primary Care Payment Reform Task Force charged with defining primary care, reporting on current primary care spend, and identify data systems to inform establishment of a primary care investment target for the state.  A version of this bill was enacted as part of S. 259, the 2023 Appropriations Bill.

Enacted as part of another bill 2023
HB 259

Charges the North Carolina Primary Care Payment Reform Task Force with developing a definition of primary care that is applicable to the NC Medicaid program and commercial insurance, measuring how much insurance plans spend on primary care, determining the quality of the primary care delivery system in North Carolina, studying the primary care payment landscape in states that implement a minimum primary care spend, and collecting data to inform a primary care investment target for insurance plans.

Enacted 2023

State Facts:

Population:
9,638,800
Uninsured Population:
16%
Total Medicaid Spending FY 2013: 
$11.9 Billion 
Overweight/Obese Adults:
66.1%
Poor Mental Health among Adults: 
30.4%
Medicaid Expansion: 
No

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