Background on the 1115 Waiver:
The State of North Carolina is transitioning the Medicaid and NC Health Choice programs from fee-for-service models to managed care. The transition to managed care will be paired with initiatives to:
(a) support and enhance the capabilities of Medicaid providers;
(b) strengthen access to care for beneficiaries; and
(c) improve health through evidence-based, health-related interventions spearheaded by public–private regional pilot programs (collectively the “ECM Pilot Program,” also known as “Healthy Opportunities Pilots”).
NC received approval of a 1115 demonstration waiver to implement these initiatives and complete the transition to managed care.
Background on the Evaluation:
Federal law requires 1115 demonstration projects be evaluated by an external, independent entity. North Carolina selected the Sheps Center to perform the required evaluation components:
(a) An evaluation of the Department’s 1115 Waiver
(b) An evaluation of the ECM Pilot Program/Healthy Opportunities Pilots
(c) A provider satisfaction survey.