Medicaid Primary Care Capitation Pilot Program

Predictable Funding for Better Rural Health

NC Medicaid is leading the development of a primary care capitation pilot program that supports rural primary care practices with predictable payments and readiness funding (Initiative 5b), advancing NCDHHS’ long-standing goal of paying for health, not just health care. The pilot falls under the NC Rural Health Transformation Program (NCRHTP) Financial Sustainability initiative.

The Medicaid Primary Care Capitation Pilot Program gives rural primary care practices the opportunity to transition to a sustainable payment model. It shifts participating practices away from fee-for-service toward predictable monthly prospective payments (capitation) paired with upfront readiness funding.

NC AHEC will help practices prepare for and succeed in this transition through education, coaching, technical assistance, and implementation support. We will help build provider awareness, operational readiness, and participation in the Medicaid Primary Care Capitation Pilot Program by communicating how NC AHEC’s education, technical assistance, and practice transformation support can help rural practices successfully transition to and thrive under the pilot.

Objectives:

• Ensure rural primary care providers understand the pilot opportunity and the support available through NC AHEC.
• Prepare primary care providers for successful participation through training, education, and technical assistance.
• Encourage primary care providers to engage with NC AHEC resources and actively participate in the pilot.

Practices do not have to navigate this operational shift alone. NC AHEC will provide hands-on training, technical assistance, and workflow guidance to ensure a seamless implementation. Customized training modules and expert support will help to minimize administrative burden, prepare practice teams for billing and care management shifts, and set clinicians up for long-term success. NC AHEC will help rural primary care providers successfully prepare for, implement, and sustain participation in the capitation pilot by providing:

• webinars and courses
• readiness toolkits
• playbooks
• office hours or learning collaborative
• coaching
• FAQ documents
• implementation guides

For more information or assistance from NC AHEC Practice Support, please email practicesupport@ncahec.net.  Visit NC Medicaid NCRHTP for more information on NC’s Rural Health Transformation Program.