But that effort was ultimately unsuccessful, with lawmakers and Gov.Pat McCrory declining to accept a proposed expansion from the federal government that would have opened up Medicaid to more low-income residents. McCrory and others argued that the state's Medicaid system is broken, and needs reform before even considering expansion.
Now with reform efforts dominating the discussion in 2014, North Carolina's hospitals and the N.C. Hospital Association plan to scale back the energy put into pushing for Medicaid eligibility expansion this year.
"We are focused exclusively right now working with the governor, the secretary (of the N.C. Department of Health and Human Services) and the legislature to reform the Medicaid system," said Hugh Tilson, an executive vice president for the hospital association who oversees advocacy efforts.
It's a financial issue for hospitals because the expansion of the Medicaid program would be to a broader population of those who are now uninsured and receive care at hospital facilities, but often are not able to pay for it. North Carolina is one of 26 states to decide against expanding Medicaid eligibility.
Hospitals view the expansion as a source of revenue for care now largely provided without charge, one needed to offset revenue declines in other areas under the Affordable Care Act.
Cone Health, has been a leading advocate for Medicaid expansion, having spent time last year in Raleigh lobbying for the move.
Rice isn't giving up on the issue and plans to push for expansion when talking with legislators this year. That said, he said he's heard from DHHS Secretary Aldona Wos and N.C. Senate President Phil Berger, an Eden Republican, that expansion is unlikely until reform has been put in place.
A Medicaid reform panel headed by Rice's predecessor at Cone, Dennis Barry, has been meeting since last year, and plans to present its recommendations to the legislature in mid-March. The expectation is there will be a Medicaid reform proposal before the legislature when it convenes for its short session in May.
Rice said he's seeing broader support for Medicaid expansion, noting actions by cities such as Chapel Hill as well as various chambers of commerce in speaking out in favor of expansion.
"If you ask from a global perspective, I'm seeing a lot more come out of communities and church groups and others saying to the legislature, 'we need to do this,'" Rice said. "There's a broader push than just from the health care industry itself."
Within the reform discussion, Rice said he's been pleased to see the discussion include the use of an accountable care model such as the one that Cone itself has been using with Triad Healthcare Network, an accountable care organization formed in 2012.
It's a model, where health care networks take on some of the risk and reward for reducing care costs and improving quality, that he believes has promise with the Medicaid population as well.
"That's gotten some attention," Rice said.
Link to original article from Triad Business Journal