Health Care System Transformation and COVID-19: The Case of Medically Complex Older Adults

This proposed pilot project is part of a broader research agenda examining how the movement toward value-based care in North Carolina impacts low-income, disabled, middle-aged adults (45-64) covered by Medicaid. North Carolina currently has a small number of innovative care models that were implemented through Medicaid waivers with the goal of delivering more patient-centered, coordinated care for this population. In addition, the State is on the cusp of transitioning its Medicaid population to mandatory managed care in July of 2021. Our project will have two aims based on this policy environment, positioning our team for a larger grant.

Aim 1: To determine the extent to which non-COVID-related care changed during the COVID-19 pandemic for community-based, low-income adults with Medicaid in North Carolina and the implications for health outcomes.

Aim 2: To evaluate the feasibility of a future study of the effects of the mandatory transition of non-dual Medicaid enrollees to MMC in North Carolina on health care costs, use and outcomes.