Managed Care Reform and Prospects for Medicaid Expansion in North Carolina

North Carolina is poised to undertake significant reforms to its $12.4 billion Medicaid program that serves two million of its residents, even as the political landscape has shifted in Raleigh and in Washington, DC. Divided government at the state level has jump-started reform in North Carolina as the newly elected Democratic Governor has invigorated the Medicaid managed care reform begun by Republicans. The lingering question is whether the state will also expand its Medicaid program. Using the key issues of rural health disparities, value-based payment arrangements, and behavioral health integration, which managed care reform aims to address, we consider how Medicaid expansion could impact the realization of managed care reform goals.