ST. LOUIS, Jan. 10, 2017 /PRNewswire/ -- Centene Corporation (NYSE: CNC) today announced it has signed a definitive agreement with the North Carolina Medical Society (NCMS), working in conjunction with the North Carolina Community Health Center Association (NCCHCA), to collaborate on a patient-focused approach to Medicaid under the reform plan enacted in the state of North Carolina.
Under the agreement, the organization will create a joint venture, Carolina Complete Health, to establish, organize and operate a physician-led health plan to provide Medicaid managed care services in North Carolina. A key feature of the joint venture will be the active participation of physicians in the ownership and governance of the health plan. Centene will manage the financial and daily operations, while the Carolina Complete Health Network, which will be owned jointly by NCMS, physicians, Physician Assistants, Nurse Practitioners and Federally Qualified Health Centers, will provide medical management services, hold a majority on the Board of Directors and oversee the medical policies for the health plan.
"With the changes taking place in our health care system at the state level with Medicaid reform and new programs at the national level, the NCMS remains committed to ensuring that physicians are the ones making the clinical decisions in the best interest of their patients," said NCMS CEO Robert W. Seligson. "Our leadership views this partnership as a unique opportunity to help lead the reform process and to put patients' needs first."
When the General Assembly in September 2015 passed Medicaid reform legislation privatizing the state's Medicaid program, the NCMS began to proactively pursue opportunities to keep patients at the forefront. The NCMS established key criteria for a partnership including financial strength, experience with statewide Medicaid networks and an openness to a patient-focused approach.
"Centene is pleased to enter into this partnership with the NCMS and NCCHCA to serve Medicaid recipients in North Carolina," said Michael F. Neidorff, Chairman, President and CEO for Centene. "We believe this physician-directed health plan can be an ideal model when properly executed to ensure providers are leading health care decisions and contributing toward a value-based reimbursement system that results in better health outcomes for members at a lower cost to the state. We have seen this type of health plan model work, and we look forward to bringing this approach to North Carolina."
Moving forward, the NCCHCA will serve as an integral part in making the joint venture a success.
"North Carolina Federally Qualified Health Centers (FQHCs) are key providers of primary care services to Medicaid recipients across North Carolina. The patient-centered medical home model at FQHCs, and their focus on providing a broad spectrum of services to low-income and underserved populations, make them uniquely prepared to meet the state's Medicaid reform goals. NCCHCA believes partnering with the North Carolina Medical Society and Centene will enable FQHCs to work more closely with physician specialists and health systems in their local communities to improve patient continuity of care, quality and cost," said NCCHCA CEO E. Benjamin Money, Jr.
About Centene Corporation
Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored programs, Medicare (including the Medicare prescription drug benefit commonly known as "Part D"), as well as programs with the U.S. Department of Defense and U.S. Department of Veterans Affairs. Centene operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.
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Without limiting the foregoing, forward-looking statements often use words such as "anticipate", "seek", "target", "expect", "estimate", "intend", "plan", "goal", "believe", "hope", "aim", "continue", "will", "may", "can", "would", "could" or "should" or other words of similar meaning or the negative thereof. We intend such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in PSLRA. A number of factors, variables or events could cause actual plans and results to differ materially from those expressed or implied in forward-looking statements. Such factors include, but are not limited to, Centene's ability to accurately predict and effectively manage health benefits and other operating expenses and reserves; competition; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies and advances in medicine; increased health care costs; changes in economic, political or market conditions; changes in federal or state laws or regulations, including changes with respect to government health care programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act and any regulations enacted thereunder that may result from changing political conditions; rate cuts or other payment reductions or delays by governmental payors and other risks and uncertainties affecting Centene's government businesses; Centene's ability to adequately price products on federally facilitated and state based Health Insurance Marketplaces; tax matters; disasters or major epidemics; the outcome of legal or regulatory proceedings; changes in expected contract start dates; provider, state, federal and other contract changes and timing of regulatory approval of contracts; the expiration, suspension or termination of Centene's contracts with federal or state governments (including but not limited to Medicaid, Medicare, and TRICARE); challenges to Centene's contract awards; cyber-attacks or other privacy or data security incidents; the possibility that the expected synergies and value creation from acquired businesses, including, without limitation, the Health Net acquisition, will not be realized, or will not be realized within the expected time period, including, but not limited to, as a result of conditions, terms, obligations or restrictions imposed by regulators in connection with their approval of, or consent to, the acquisition; the exertion of management's time and Centene's resources, and other expenses incurred and business changes required in connection with complying with the undertakings in connection with certain regulatory approvals; disruption from the acquisition making it more difficult to maintain business and operational relationships; the risk that unexpected costs will be incurred in connection with, among other things, the acquisition and/or the integration; changes in expected closing dates, estimated purchase price and accretion for acquisitions; the risk that acquired businesses will not be integrated successfully; Centene's ability to maintain or achieve improvement in CMS Star ratings and other quality scores that impact revenue; availability of debt and equity financing, on terms that are favorable to Centene; inflation; foreign currency fluctuations; and risks and uncertainties discussed in the reports that Centene has filed with the SEC. These forward-looking statements reflect Centene's current views with respect to future events and are based on numerous assumptions and assessments made by Centene in light of its experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors it believes appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future. The factors described in the context of such forward-looking statements in this press release could cause Centene's plans with respect to the Health Net acquisition, actual results, performance or achievements, industry results and developments to differ materially from those expressed in or implied by such forward-looking statements. Although it is currently believed that the expectations reflected in such forward-looking statements are reasonable, no assurance can be given that such expectations will prove to have been correct and persons reading this press release are therefore cautioned not to place undue reliance on these forward-looking statements which speak only as of the date of this press release. Centene does not assume any obligation to update the information contained in this press release (whether as a result of new information, future events or otherwise), except as required by applicable law. This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other risk factors that may affect Centene's business operations, financial condition and results of operations, in Centene's filings with the SEC, including the annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.
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