Bob Atlas Quoted in “N.C. Again Mulls Move to Medicaid Capitation, but Divisions Persist”

Medicare Advantage News

Bob Atlas, a Strategic Advisor and President of EBG Advisors, Inc., was quoted in Medicare Advantage News, in “N.C. Again Mulls Move to Medicaid Capitation, but Divisions Persist.”

Following is an excerpt:

“I cannot handicap that one,” Bob Atlas, who is president of the EBG Advisors unit of health care law firm Epstein Becker and Green and serves as a consultant to the North Carolina Department of Health and Human Services (DHHS), tells MAN. The state House and Senate “seem to be in a stalemate,” he explains, with the Senate pushing hard for full Medicaid managed care and the House wanting to have provider-led Medicaid reforms. …

One of the newest debates between proponents and opponents of Medicaid managed care in North Carolina concerns cost figures from the legislature’s nonpartisan fiscal research division that appear to show the state’s medical cost growth trend leveling off. While providers have used these data to argue that full Medicaid managed care isn’t needed, the overall cost trend actually continues to be up if all of the recent changes in the state’s Medicaid program are figured in, according to Atlas. Those changes, he notes, include the demographic mix of North Carolina Medicaid beneficiaries moving more toward children, who tend to have lower costs. If this downward bias and the payment-rate changes adopted by the legislature are figured in, “the secular [cost] trend is not necessarily under control,” Atlas asserts. He adds that there also are nonfinancial issues to consider when the state decides whether to take the plunge into Medicaid managed care. Under the current North Carolina Medicaid structure, says Atlas, no party is either rewarded or penalized for patient outcomes, so quality and access to care remain big issues. “The underlying basis for reform is still present,” he contends, “yet apparently is not compelling enough…to force a meeting of the minds of disparate political interests.”