Douglas McCarthy, Kimberly Mueller
Community Care of North Carolina (CCNC) is a public–private partnership between the state and 14 nonprofit community care networks. The networks comprise essential local providers that deliver key components of a "medical home" for low-income adults and children enrolled in Medicaid and the State Children's Health Insurance Program. Community-based delivery systems promote the development of locally led approaches that leverage resources and relationships to meet statewide goals. Local networks and primary care physicians receive supplemental funding for care management and quality improvement initiatives supported by statewide performance measurement and benchmarking activities. Results suggest that the program has yielded cost savings while promoting improvements in care of patients with chronic conditions. CCNC's experience may be relevant to other states considering how to improve primary care case management programs, or how to better address the needs of low-income individuals in areas that lack effective mechanisms for coordinating care.
This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.