Why Pediatricians Have Concerns About a Medicaid Plan With 15 Provider-Led Entities

When a child comes to either of our pediatric offices, the chances are high that he or she is insured through Medicaid. Unlike adults, who comprise a relative handful of Medicaid patients, 40% of children in North Carolina are insured by Medicaid; indeed, children comprise 70% of all Medicaid recipients. Throughout the decades, Medicaid in North Carolina has worked well for children and the professionals who care for them. Because it serves primarily children, Medicaid has developed strong, cost-effective systems for their care. Through Community Care of North Carolina (CCNC), for instance, pediatricians can access useful tools to assure that patients with the greatest needs get the comprehensive services they require. Pediatricians are thus concerned about the proposed Medicaid waiver because we fear it may erode Medicaid's strengths and make it harder for us to serve the children who are most in need. Because many children will be affected by the proposed Medicaid changes, the professionals who provide their health care have a huge stake in any proposed changes. As pediatricians noted during both the legislative process and the extensive public hearings held by the North Carolina Department of Health and Human Services (DHHS), the proposed Medicaid waiver will increase administrative burdens for pediatricians and pediatric subspecialists while likely decreasing access to care for patients throughout the state. As pediatricians in independent practices, we are concerned that under the waiver plan we will spend more time figuring out how to make the system work and less time interacting with patients…