The Department’s goal is to improve the health of North Carolinians through an innovative, whole-person centered, and well-coordinated system of care and measurement of quality, which addresses both medical and non-medical drivers of health.

As North Carolina transitions to NC Medicaid Managed Care, the Department will work with Prepaid Health Plans (PHPs) to develop a data-driven, outcomes-based continuous quality improvement process, This will:

• Focus on rigorous outcome measurement compared to relevant targets and benchmarks,

• Promote equity through reduction or elimination of health disparities, and

• Appropriately reward PHPs and, in turn, providers for advancing quality goals and health outcomes.

To learn more about NC Medicaid Managed Care and the work that NCDHHS does, go here: NCDHHS Medicaid Transformation

NC Medicaid Provider Playbook:

A place where you can access the latest information, tools and other resources to help you and your patients smoothly transition to Medicaid Managed Care. Visit the Provider Playbook often as resources will be added as they become available.

Click here to navigate NC Medicaid Provider Playbook

Quality Strategy

The Department’s Quality Strategy details Medicaid Managed Care aims, goals and objectives for quality management and improvement and details specific quality improvement (QI) initiatives that are priorities for the Department.

Source: NCDHHS