North Carolina medical journal
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As North Carolina's Medicaid program transitions from fee-for-service to managed care, the Department of Health and Human Services is committed to building an innovative, whole-person-centered and well-coordinated system of care that addresses both medical and non-medical drivers of health. Delivering on that vision, and improving the health and well-being of North Carolinians, means shifting from thinking of payers as exclusively buying medical services to thinking of them as buying health for their beneficiaries. Operationalizing this complex work will require strong partnership from stakeholders across the state and will also provide North Carolina an opportunity to help drive a national agenda centered around how to buy good health.
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North Carolina's move to Medicaid managed care is part of the larger move to value-based care nationally. Keys to value-based care guide how practices and health systems can navigate the new payment model. The experience of North Carolina's Area Health Education Centers with primary care practices that work on value-based care can serve as an important case study.
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Federal managed care rules require that the services delivered through Medicaid prepaid health plans are available, accessible, and continually being evaluated for improvement. Working with stakeholders, NC Medicaid created a Quality Strategy that serves as a roadmap to measure and oversee performance. NC Medicaid will make a variety of quality reports available including network access, annual quality measures, and provider survey results.
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BACKGROUND Despite evidence linking rapid defibrillation to out-of-hospital cardiac arrest (OHCA) survival, bystander use of automatic external defibrillators (AEDs) remains low, due in part to AED placement and accessibility. AED-equipped drones may improve time-to-defibrillation, yet the benefits and costs are unknown. METHODS We designed drone deployment networks for the state of North Carolina using mathematical optimization models to select drone stations from existing infrastructure by specifying the number of stations and the targeted AED arrival time. ⋯ Sensitivity analysis demonstrated that an AED drone network remained cost-effective over a wide range of assumptions. CONCLUSIONS With proper integration into existing systems, large-scale networks for drone AED delivery have the potential to substantially improve OHCA survival rates while remaining cost-effective. Public health researchers should consider advocating for feasibility studies and policy development surrounding drones.
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In North Carolina, total health care employment increased by 70% between 2000 and 2016. Many health care professions are evolving and experiencing rapid growth due to changes in the professions themselves and in how these workers are being utilized in the health care environment. Academic institutions must stay abreast of trends in health care workforce needs including new and emerging professions.