Provider Led

We are committed to the continued involvement of clinical leaders across North Carolina in our program design and plan governance.

Ongoing Physician Involvement:

  • Community Physician Advisory Council
  • Quality Committee
  • Utilization Management Committee
  • Pharmacy and Therapeutics Committee

Rewarding Physicians for Value

Medical Home Value

CURRENT:
PCCM Payments to Providers

FUTURE:
Ongoing support for Medical Home Value through continued PCCM payments

Care Management

CURRENT:
PMPM To Community-based Management entities

FUTURE:
PMPM to Physicians to support preferred method for care management as reflected in our care management overview

New: Quality Incentive and Value Sharing Plans

Quality Incentives:
Additional earnings based on achieving quality results and other health outcome measures.

Value Sharing Plans:
Based on provider readiness. Shared savings and risk arrangments.

Amounts available to be based on state funding.