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Improvements to Inmate Healthcare Reimbursement and Internal Processes Could Save $5.6 Million Annually (October 2018)


North Carolina provides health services to inmates at a cost of $322 million annually, an $89 million increase from 10 years ago. The Program Evaluation Division (PED) found the Department of Public Safety’s Health Services division (DPS Health Services), which manages and delivers inmate healthcare services, is partially funded by lapsed salaries and cannot demonstrate results from cost-containment efforts. PED also found statutory and contractual payment arrangements cause the State to reimburse community providers at rates higher than other states. Further, chronically vacant health services positions and subsequent reliance on contract staff costs $25 million annually, and the limited use of telemedicine has contributed to unnecessary costs. Finally, DPS Health Services’s methods for pursuing federal Medicaid funding for community services has been unsuccessful. The General Assembly should direct DPS Health Services to conduct a salary study of healthcare positions, seek federal reimbursement for Medicaid-related staff activities, modify data collection and submission methods for Medicaid applications, develop a plan for implementing telemedicine, and improve supply management practices and services. Further, the General Assembly should modify state law to reduce community provider reimbursement rates and consider establishing a data analysis position and realigning DPS Health Services’s base budget.

Final Report

Executive Summary


Full Presentation with Audio Narration (YouTube)

Full Presentation with Audio Narration (mp4)

Presentation of Findings and Recommendations

Report Series Digest

Relevant Legislation:

Agency Actions:

Press Coverage:

PED Contact:

Program Evaluation Division, North Carolina General Assembly
Legislative Office Building, Suite 100
300 North Salisbury Street , Raleigh, NC 27603-5925