DATE: Wednesday, May 7, 1997                TAG: 9705070463

SECTION: LOCAL                   PAGE: B1   EDITION: NORTH CAROLINA 

SOURCE: BY ANNE SAITA, STAFF WRITER 

DATELINE: ELIZABETH CITY                    LENGTH:   55 lines

MEDICAID PATIENTS IN ALBEMARLE COULD GET NEW HEALTH CARE SYSTEM

Medicaid patients with a wide range of health care services may find their options limited under a managed care system being considered for northeast North Carolina.

At the same time, these patients should have better access to physicians and medical specialists through the growing statewide insurance program.

Leaders from several Albemarle counties met Tuesday in Elizabeth City to discuss joining Carolina Access, a network now being used in 47 of North Carolina's 100 counties.

Pasquotank, Camden, Currituck and Perquimans counties are considering forming one multicounty unit, which would collectively serve about 7,000 eligible Medicaid recipients.

Carolina Access operates much like a health maintenance organization - patients select a primary physician and use hospital emergency rooms only for life-threatening illness or injury.

Among those eligible under the program would be anyone receiving Aid to Families With Dependent Children.

Medicaid recipients not eligible for the managed care program include foster children, who may have trouble quickly switching physicians if they move, and women on Medicaid only for the duration of a pregnancy.

Carolina Access is expected to cut down on ``doctor hopping'' and emergency medical services abuse, saving taxpayers hundreds of thousands of dollars annually.

It also encourages more preventative care, which adds to the cost-savings through fewer treatments for acute health problems.

``Most of us have a doctor that we regularly go to. That's not true with Medicaid patients,'' Frances Sawyer, director of Currituck County's Department of Social Services, told county commissioners Monday night.

Carolina Access, like other managed care programs, discourages hospital emergency room visits for routine illnesses.

``One of the reasons people go to the emergency room for colds or whatever is because they haven't been able to access the primary care physician,'' said Judy Walton, the managed care administrator for the North Carolina Department of Medical Assistance, which runs the Medicaid program statewide.

More physicians, including some that have previously turned away Medicaid patients, favor the Carolina Access program.

Medicaid is funded with federal, state and local tax dollars. Most of the funding - 65 percent - comes from the federal government. The program serves between 800,000 and 900,000 people in North Carolina, Walton said.

Several localities within the Albemarle area have been approached about forming a multi-county Carolina Access program.

Pasquotank, Camden, Currituck and Perquimans have expressed an interest. Chowan County declined to either form its own program or join one in Washington County. Gates County's social services department also said no because it currently lacks a director.

The program also is supported by Albemarle Hospital, the regional medical center that serves all four interested counties.

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