North Carolina Launches Major Effort to Transform State’s Health Care
Transforming the U.S. health care system requires collaboration at multiple levels, including patients, providers, payers, and state and federal agencies. North Carolina is one only of four states selected to catalyze progress in health care as a State Transformation Collaborative (STC), a public-private partnership to improve health for North Carolinians. The NC STC launched earlier this month at an on-campus event hosted by the Duke-Margolis Center for Health Policy and featured leaders from the North Carolina Department of Health and Human Services (NC DHHS), the Health Care Payment Learning & Action Network (LAN), and the Centers for Medicare & Medicaid Services (CMS).
“North Carolina is a great place to host the STC because it has such a strong history of collaboration,” said Mark McClellan, Director of Duke-Margolis and co-chair of the Guiding Committee for LAN. “People may have different political views, different backgrounds, or somewhat different priorities that can all come together . . . And we’ve seen that progress on health care transformation happens here both through private sector perspectives coming together and through efforts by the state government.”
The NC Collaborative bridges the gap between stakeholders with the shared goal to work together to transform the state health care system. NC DHHS Secretary Kody Kinsley underscored that, as the national system stands now, “we spend an exorbitant amount of money on health care in this country on very little output relative to the dollar.” The STC partnership advances value-based care, as “it creates the right ingredients for more meaningful and aggressive success, which we are in desperate need of—the current trajectory is not sustainable,” noted Sec. Kinsley.
The central goal of the NC STC is to improve patients’ health and health care experience while reducing costs and minimizing administrative and other burdens on providers. Achieving this goal comes back to affordability and accessibility of health care. “We can't change the way that people experience health care if we're not changing the way that we pay for health care,” said Kate Davidson, Director of the Learning and Diffusion Group at the Center for Medicare and Medicaid Innovation (CMMI). Transitioning to value-based payments is key to making that change, and is one of the proposed long-term goals for the NC STC.
Other goals are to address the need to share data, align quality measurement, and enhance health equity data to identify communities and clinical areas with persistent disparities. Dr. McClellan summarized the STC’s commitment to health equity as creating “care that doesn’t leave anyone behind.” Part of this vision is ensuring that all patients have access to the care they need, and that the services they receive are high-quality.
Sec. Kinsley emphasized that these accessible, high-quality services must include behavioral health. “There is no health without behavioral health,” he said. This topic became a talking point during the open Q&A session, where the speakers agreed that behavioral health, and other under-resourced clinical areas, will be built into the work of the NC STC.
The event closed with a fireside chat between Dr. McClellan and Purva Rawal, Chief Strategy Officer of CCMI. She summarized five key objectives to advance health system transformation:
- Drive accountable care with a focus on advanced primary care models
- Advance health equity through data collection
- Support innovation in quality measurement
- Address affordability and reduce costs
- Partner to achieve system transformation through collaboration
Dr. Rawal pointed out that the NC STC could be a powerful blueprint for other states as North Carolina stakeholders will learn what works, what doesn’t, and can then refine the process for other STCs.
Now officially launched, the NC STC focus is on next steps. In the coming weeks and months, NC STC stakeholders will develop a workplan for the Collaborative, meet regularly with federal partners and the three other STC states—Colorado, Arkansas, and California—and inform forthcoming federal rulemaking and activities relevant to the STC initiative.
Patients and communities are crucial to the NC STC effort. Share your perspective via the NC STC priorities survey. Public feedback will inform the initiative’s efforts, priorities, goals, and ultimately its success.