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Last July, North Carolina launched what NC DHHS termed “Medicaid Transformation.” This included the transition of the state’s Medicaid program to  Managed Care, where the payment and administration of (most) Medicaid services is now delegated to private Prepaid Health Plans. This transition to managed care was long anticipated and has been the subject of a great deal of national attention as an example of the state as a “laboratory for innovation” for Medicaid policy and design.    We are now many months into Medicaid Transformation, and with the first frenetic months of implementation behind us, it is worth stepping back and reviewing Medicaid Transformation as a whole. While Transformation has brought about significant changes to North Carolina’s Medicaid program, it is important to understand that, by and large, when it comes to most of the program’s design and delivery it is not particularly innovative. Instead, the model rep

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