In 1998, the Division of Medical Assistance and the Office of Rural Health and Community Care once again collaborated to enhance the basic Carolina ACCESS program and launched a new approach to providing health care for Medicaid recipients. CCNC operates statewide. CCNC works directly with community providers who have contracted with the state to be a Carolina ACCESS PCP. The program builds private and public partnerships where community providers and resources plan cooperatively for meeting patient needs.
The responsibility for managing the care of the enrolled population falls to the community network. Performance and improvement are the responsibility of those who actually deliver the care. Medical providers are paid fee for service and PCPs participating in a network are paid a management fee based on PM/PM. The network in which the provider is enrolled also receives a management fee based on the number of Medicaid recipients enrolled with the network. All funds are kept local and recycle back into the community for patient care. Because health care is planned and provided on the community level, larger community health issues can be addressed.
A majority of Medicaid recipients enrolled in managed care are linked with a CCNC network. There are fourteen (14) networks operating statewide. These networks are private non-profit and contract with the state which provides operating expenses for staff and health care initiatives.