North Carolina AHEC Program
winter 2014 newsletter | home
I write to you after three months as director of the NC AHEC Program in order to give an update about what is going on across the state and where AHEC fits in.
I am now about half done with my “listening tour” of North Carolina. So far I have been able to give initial visits to Wake AHEC in Raleigh, Southern Regional AHEC in Fayetteville, Northwest AHEC in Winston-Salem, Eastern AHEC in Greenville, and brief visits at South East AHEC in Wilmington, Area L AHEC in Rocky Mount, and Mountain AHEC in Asheville. Thank you for your hospitality! I am meeting AHEC staff and leaders, as well as the hospital leadership and other key NC AHEC partners. In addition to these site visits, I have met with most of the NC AHEC health professions discipline groups, the deans of the relevant schools at The University of North Carolina at Chapel Hill and quite a number of statewide stakeholders including legislators and the Governor’s administration.
What have I learned so far? With respect to health care across North Carolina, my biggest learning is that transformative change is continuing. Three months ago, when I began my position as NC AHEC Program director, I asserted that what was going on was not just usual change but transformative change in the health care system. Nothing that has happened in the last three months would make me retract that assessment. Since September 1, two senior health system leaders and the director of Medicaid have been removed abruptly; financial challenges at some of our large integrated systems have led to layoffs, and one institution has begun to cut back on resident graduate medical education, paralleling what has begun to happen nationally in a few institutions.
NCTracks (the new multi-payer Medicaid Management Information System for the NC Department of Health and Human Services) is improving modestly, and the tone of the discussion about Medicaid reform in Raleigh has changed notably, with increasing recognition that Medicaid spending on clinical services has actually increased less in North Carolina than in other states. The NC State Health Plan, which is the largest single commercial insurer in the state, is proceeding with a significant redesign of benefits, emphasizing smoking cessation, selection of primary care provider and wellness, while creating an option for consumer directed health care, and many of the major integrated systems are putting together clinically integrated networks and accountable care organization (ACO) products. Finally, the NC AHEC Program report on primary care attracted a great deal of interest both at the UNC Board of Governors level and among legislators, and we have been asked to bring recommendations back about improving the primary care workforce across the state.
I believe these changes represent a great opportunity for us. My visits have given me a deep appreciation for the breadth and quality of what the NC AHEC Program is doing across the state—we are engaged in so many thoughtful and creative responses to the needs of our many communities, grounded in excellent relationships with the people over time. Moreover, throughout the state, health system leaders and politicians and health professionals trust the NC AHEC Program and look for its help in dealing with some of the most challenging problems they face. I do not think that this trust should be a surprise. I was also impressed, however, that many of our AHEC staff on the ground are sometimes not aware of what is being done in other AHECs. I think the explanation is mostly that we AHEC-ers are a humble lot—we are just trying to be helpful in our region and we don’t self-promote very much. But we need to speak up more, both to spread good ideas and to help expand support for what we do in the future.
On December 12, the NC AHEC Program Statewide Conference was held to help address these issues. The conference had two major objectives—to share innovations and best practices across the state and across professions, and to get input from our statewide community about the future of the NC AHEC Program in the setting of the dramatic changes coming to health care. The impressive list of innovations presented at this meeting can be seen here. As for the future of the NC AHEC Program, I can only say that we stand at the ready to find the very best ways to help ease this great transformation that is happening. By working together, we can continue to create a better state of health for all the people of North Carolina. I look forward to working with all of you.
Warren P. Newton, MD, MPH
Vice Dean & Director, NC AHEC Program