{"doi":"10.18043/001c.83956","title":"Perceptions of North Carolina’s Medicaid Transformation: A Qualitative Study","abstract":"BACKGROUND: In 2021, North Carolina switched 1.6 million beneficiaries from a fee-for-service Medicaid model to a managed care system. The state prepared beneficiaries with logistical planning and a communications plan. However, the rollout occurred during the COVID-19 pandemic, creating significant challenges. Little is known about how Medicaid Transformation impacted the experience of Medicaid enrollees. METHODS: We conducted four focus groups (N = 22) with Medicaid beneficiaries from January to March 2022 to gain insight into their experience with Medicaid Transformation. A convenience sample was recruited. Focus groups were recorded, transcribed verbatim, and verified. A codebook was developed using inductive and deductive codes. Two study team members independently coded the transcripts; discrepancies were resolved among the research team. Themes were derived by their prevalence and salience within the data. RESULTS: We identified four major themes: 1) Participants expressed confusion about the signup process; 2) Participants had a limited understanding of their new plans; 3) Participants expressed difficulty accessing services through their plans; and 4) Participants primarily noted negative changes to their care. These findings suggest that Medicaid enrollees felt unsupported during the enrollment process and had difficulty accessing assistance to gain a better understanding of their plans and new services. LIMITATIONS: Participants were recruited from a single institution in the Southeastern United States; results may not be transferable to other institutions. Participants were likely not representative of all Medicaid Transformation beneficiaries; only English-speaking participants were included. CONCLUSION: As the transition process continues, the North Carolina Medicaid program can benefit from integrating recommendations identified by member input to guide strategies for addressing whole-person care.","journal":"North Carolina Medical Journal","year":2023,"id":375145,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9366,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":721788,"name":"Amresh Hanchate","orcid":"0000-0002-7038-4463","position":1,"is_corresponding":false},{"id":435640,"name":"Deepak Palakshappa","orcid":"0000-0003-1467-4965","position":2,"is_corresponding":false},{"id":1137817,"name":"Aylin Aguilar","orcid":null,"position":3,"is_corresponding":false},{"id":479679,"name":"Kimberly D. Wiseman","orcid":"0000-0003-1497-8512","position":4,"is_corresponding":false},{"id":1137818,"name":"Charlotte Crotts","orcid":null,"position":5,"is_corresponding":false},{"id":1137819,"name":"Lindsay Abdelfattah","orcid":null,"position":6,"is_corresponding":false},{"id":1137820,"name":"Sheena McNeill","orcid":null,"position":7,"is_corresponding":false},{"id":1137821,"name":"Daniel Sostaita","orcid":null,"position":8,"is_corresponding":false},{"id":435637,"name":"Kimberly Móntez","orcid":"0000-0003-0247-3664","position":9,"is_corresponding":false},{"id":435639,"name":"Rachel Zimmer","orcid":"0000-0003-1037-069X","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T01:16:19.336238Z","pmid":"38919377","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}