Our Results

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Our Results

Making headway on cost and quality

CCNC's population-based, doctor- and data-driven approach to health care is saving money while improving the care delivered to CCNC enrollees. This result has been confirmed by several leading consulting firms.

Treo Solutions (Utilization)
While other studies detailed in this space document substantial cost savings from CCNC, the latest report from Treo Solution analyzes CCNC’s impact on the utilization of services that gave rise to those savings.

The 2007-2010 healthcare utilization patterns and trends of the populations enrolled in Community Care of North Carolina (CCNC) are consistent with high-performing primary care medical homes. Inpatient and ER utilization are consistently lower for the CCNC-enrolled population while primary care visits and pharmaceutical prescriptions are higher.

Generally, favorable utilization patterns for the CCNC-enrolled population are seen at the:

1. Overall population level (enrolled vs. unenrolled);
2. Within each CCNC population segment (ABD, Adult Non-ABD, and Child Non-ABD); and
3. Among specific population health status cohorts as determined by aggregated Clinical Risk Groups (e.g., children with asthma or adults who are categorized as having two or more chronic conditions). Even among the heaviest users of health care services, the CCNC-enrolled population continues to demonstrate a pattern of lower inpatient and ER utilization and higher PCP visit and prescription rates than does the unenrolled Medicaid population.

It is important to note that these favorable utilization trends occurred amid a significant increase in the both the population served by CCNC (+271,000 recipients) and the overall illness burden of the enrolled population (+7%) with the addition of the Aged, Blind and Disabled Population.

For details on Treo Solution’s analysis, please see the Related Download at right.

Milliman (cost)
A December 2011 analysis by Milliman, Inc, a national consulting firm based in California, found that CCNC saved the State of North Carolina nearly a billion dollars in health care costs over the four-year period from fiscal year 2007 through fiscal year 2010. The year-by-year breakdown is noted below. See the Governor's Press Release and Milliman's Executive Summary for more information.

State Fiscal Year	Per-Member, Per-Month	Total Annual Savings
2007	$8.73	$103,000,000
2008	$15.69	$204,000,000
2009	$20.89	$295,000,000
2010	$25.40	$382,000,000

Treo Solutions (cost)
An analysis by health care analytics consultant Treo Solutions, Inc. found that CCNC saved nearly $1.5 billion in health care costs from 2007 through 2009.

Using the unenrolled fee-for-service population, risk adjustments were made by creating a total cost of care (PMPM) set of weights by Clinical Risk Group (CRG), with age and gender adjustments. This weight set was then applied to the entire NC Medicaid Population. Using the FFS weight set and base PMPM, expected costs were calculated. This FFS expected amount was compared to the actual Medicaid spend for 2007, 2008, 2009. The difference between actual and expected spend was considered savings attributable to CCNC.

Mercer, Inc (cost)
Earlier studies by Mercer estimated CCNC savings as:

State Fiscal Year	Estimated Savings
2005	$77 - $81M
2006	$154 - $170M
2007	$135 - $149M
2008	$156 - $164M
2009	$186 - $194M

For more information on financial and quality results, please contact Director of Communications Paul Mahoney.

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