About AccessCare

AccessCare is a network of primary care physicians committed to providing the highest quality medical care for the Medicaid, Medicare, and uninsured populations of North Carolina.  As a 501(c)(3) not-for-profit organization, AccessCare was designed to improve access to medical services, maintain quality of care, and reduce costs of care for its clients.  Established in July 1998 as a member owned not-for-profit of 23 practices, AccessCare has grown to a statewide network of over 300 primary care practices with 1,000 providers caring for 200,000 Medicaid enrollees as of January 2007.

AccessCare is the largest of fourteen local networks of primary care providers that contract with North Carolina’s Department of Health and Human Services to develop disease management and case management initiatives and coordinate prevention, treatment and other services.  This system of networks, coordinated by Community Care of North Carolina, enhances the Carolina ACCESS Medicaid program by developing physician-led community partnerships to improve care and reduce costs by connecting Medicaid enrollees with a medical home.

AccessCare is owned by its provider members who elect member physicians and other North Carolina health care leaders to serve on the organization’s Board of Directors.

Specific AccessCare initiatives include:

• Creating unique web-based information technology systems throughout its network;
• Establishing targeted disease management programs, authorization processes, and after-hours protocols;
• Coordinating case management of high risk populations; and
• Developing specific strategies to address the special needs of the enrolled population.

AccessCare operates within a fee-for-service model with an enhanced case management fee.

History

Since April 1991, the Medicaid program of North Carolina has operated within the framework of Carolina ACCESS, a primary care coordination program. Carolina ACCESS was developed in an effort to create a more efficient and effective health care system for Medicaid enrollees by enhancing access to primary care and improving the coordination of medical services for the underserved.  The program emphasizes a working partnership between the state and local communities, with primary care providers playing a pivotal role in program development and operation.  In addition, under Carolina ACCESS, recipients are assured access to a continuity of care through assignment to a primary care provider.

AccessCare was founded in 1998 as one of nine physician networks tasked with enhancing the existing Carolina ACCESS Medicaid program by developing physician-led community partnerships with disease management programs and employment of locally-based case managers. These networks are coordinated by Community Care of North Carolina (CCNC), which assists local providers in developing managed care delivery systems that coordinate a continuum of health care with processes to influence cost and quality.  The program is administered by the North Carolina Office of Research, Demonstration, and Rural Health Development and is sponsored by the Division of Medical Assistance (DMA) and the North Carolina Foundation for Alternative Health Programs, Inc.