Happy New Year, North Carolina Practice Managers and Staff!

As we begin 2026, the landscape of childhood immunizations is shifting—bringing both confusion and opportunity for clarity. The latest update from the CDC, following a Presidential directive to align U.S. recommendations with “peer nations” like Denmark, has resulted in significant changes to the recommended vaccine schedule for children. Here’s what you need to know, and how to support your teams and families through this transition.

What’s Changed?

• Fewer Routine Vaccines: The CDC now routinely recommends vaccines for 11 diseases instead of 17. For example, the HPV vaccine moves from a 2-dose to a 1-dose schedule.
• Risk-Based & Shared Decision-Making: Several vaccines previously recommended for all children are now either:
  • Recommended only for high-risk groups: RSV (for children whose mothers didn’t get the pregnancy vaccine), Hepatitis A, Hepatitis B, Meningococcal.
  • Left to “shared clinical decision-making” (SCDM): Rotavirus, COVID-19, Influenza, Hepatitis A, Hepatitis B, Meningococcal. This means clinicians and families decide together, based on individual risk and benefit.
• No Change for Pediatric Vaccines Coverage: Medicaid and Prepaid Health Plans (PHPs) have not changed their position—coverage for pediatric vaccines remains unchanged at this time.

New HHS Childhood Immunization Schedule (Released January 5, 2026)

Key Points for Your Practice

1. Access Remains: Families can still access the full range of childhood immunizations recommended by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). The AAP schedule remains unchanged and is available .
2. No Out-of-Pocket Cost: All vaccines—including those now under SCDM—are still covered with no out-of-pocket cost by ACA-regulated private insurance, Medicaid, and the Vaccines for Children (VFC) program. HHS has affirmed this commitment.
3. Evidence Is Unchanged: The scientific evidence supporting the full AAP and AAFP vaccination schedules remains robust. These changes do not reflect new safety or efficacy concerns.
4. Anticipate Challenges: Expect confusion and operational challenges around school vaccine requirements, clinical workflows, and supply of combination vaccines. Clear communication and updated workflows will be essential.

Practical Guidance for Practice Managers & Staff

• Continue to Offer and Recommend Vaccines: Pediatricians and primary care teams can still offer vaccines according to the evidence-based U.S. schedule. Parents can request them, and clinicians should reassure families about continued access and coverage.
• Update Clinical Workflows: Integrate prompts and education into EHRs and point-of-care tools to maintain routine vaccination workflows and avoid missed opportunities.
• Communicate Clearly: Use talking points that focus on health outcomes (illnesses prevented, hospitalizations avoided) rather than the number of vaccines. Emphasize that fewer vaccines does not mean better health outcomes.
• Monitor for Policy Updates: Stay tuned for further guidance from NC Medicaid, VFC, and state health agencies. Forward any updates you receive to the NC Immunization Coalition (NCIC) and share with your teams.
• Educate Staff and Families: Address misconceptions proactively. For example:
  • The U.S. is not an outlier—most peer nations have schedules similar to ours, not Denmark’s.
  • The broader U.S. schedule exists to fill gaps in healthcare access and disease screening.
  • The Hep B birth dose is a critical safety net, especially given gaps in maternal screening and follow-up in the U.S.
  • Combination vaccines help reduce the number of shots, not the level of protection.

North Carolina Secures $213 Million to Transform Rural Health Care

We’re excited to share a major milestone for rural health in North Carolina. The Centers for Medicare & Medicaid Services (CMS) has approved North Carolina’s application for the Rural Health Transformation Program (RHTP), unlocking over $213 million in first-year funding to strengthen health care delivery across 85 rural counties.

This achievement reflects collaboration with more than 420 stakeholders, including rural hospitals, community health centers, local health departments, Tribal communities, and community- and faith-based organizations. It underscores North Carolina’s long-standing commitment to ensuring rural residents have access to high-quality, affordable care.

Why This Matters

North Carolina has the second-largest rural population in the nation, facing unique challenges in access, workforce, and infrastructure. The RHTP introduces six key strategies to address these needs:

• Expand behavioral health services
• Invest in the rural health workforce
• Improve prevention and chronic disease management
• Support providers transitioning to value-based care
• Enhance health care technology
• Launch NC ROOTS Hubs to connect medical, behavioral health, and social supports

What’s Next

Implementation will involve a broad coalition of state agencies, rural providers, community partners, academic institutions, and the private sector. Once funding is received, NCDHHS will:

• Establish a statewide governance structure
• Begin building regional hubs
• Engage stakeholders in funding and implementation decisions

To keep the conversation going, NCDHHS will host a virtual town hall on Friday, Jan. 16 to share program goals, next steps, and statewide impact. Details and registration will be available soon on the https://www.ncdhhs.gov.

Impact at a Glance

• Nearly 3 million rural North Carolinians supported
• More than 400 rural health facilities strengthened
• $213 million in federal investment for year one

This is a transformative moment for rural health in North Carolina, and we look forward to working together to make it a success.

Would you like me to make this more conversational and blog-friendly (with a warm tone and call-to-action), or keep it formal and policy-focused for professional audiences?

Welcome to Your 2025 Wrapped

If 2025 were a playlist, it would be an epic mix of resilience, innovation, and hard work. As we close out the year, we wanted to take a moment to look back at the "music" we made together.

This year, practice managers and staff across our region didn't just keep the rhythm—you set the tempo for better healthcare in Northwest North Carolina. From navigating complex payer changes to launching new care models, you turned challenges into chart-topping successes.

Here is what your year sounded like, according to the numbers.

📊 The "Minutes Listened" (Our Impact by the Numbers)

You were incredibly busy this year. While much of the healthcare world was just tuning in, you were logging serious hours to improve access and quality.

• Total Practice Coaching Encounters: 2,297
  • That represents nearly 2,300 specific touchpoints where we worked side-by-side with you to solve problems and improve care.
• Top Region on the Charts: Ashe County ⛰️
  • Ashe County was our "Top Artist" this year with 164 encounters, proving that rural health remains the heartbeat of our region.
• The Rising Hits:
  • Alleghany and Alexander counties also topped the setlist, keeping the momentum strong across our footprint.

🎹 Your Top Genre: Medicaid Managed Care

If 2025 had a main genre, it was definitely Medicaid Managed Care.

Just like in previous years, this was the beat driving most of our work. Whether it was deciphering the Standardized Performance Incentive Program or navigating Advanced Medical Home (AMH) tier support, you stayed in sync with the state's biggest changes.

Your Top Sub-Genres (Trending Topics):

• Billing & Coding: The technical solos that kept your revenue cycle moving.
• Practice Management Operations: The daily rhythm of running an efficient office.
• Quality Payment Program (QPP): The critical performance reviews that ensured you got credit for your quality care.

💿 The "Viral Hits" (Top Stories of 2025)

Every year has those standout tracks that everyone talks about. These were the success stories and resources that defined 2025 for our network.

• The Story: Facing a surge in mental health needs, the team at Twin City Pediatrics implemented the Collaborative Care Model (CoCM).
• The Result: By June 2025, they didn't just launch—they became revenue-positive six months ahead of schedule. It was the feel-good hit of the summer and a blueprint for others to follow.

 The Indie Favorite: Fall Risk Assessment 

• The Story: Released in June, the self-paced course Falls: Screening, Risk Assessment and Care Planning became an instant essential for clinicians working with older adults.
• The Vibe: Since its debut on 6/16/25, it has racked up 223 registrations. By focusing on the STEADI framework, you proved that keeping patients safe and steady is a timeless classic that never goes out of style.

• The Story: With the announcement that the Clear Pricing Project ends on Dec 31, 2025, we shifted focus to transition planning.
• The Shift: You worked hard to prepare for the move away from CPP and into new fee schedules for 2026, ensuring your practices remain financially stable during the switch.

🔮 Your "Musical Aura" for 2026

Based on your listening habits late in the year, 2026 is shaping up to be a year of Innovation & Resilience.

We are already queuing up tracks on AI in Clinical Decisions, Cybersecurity, and leveraging the newly relaunched NC AHEC Digital Library. The setlist for next year is going to be exciting, and we can't wait to explore it with you.

Thank you for a chart-topping 2025!

Here’s to keeping the beat going in the New Year.

— The NW AHEC Practice Support Team

Need help planning your 2026 playlist? Reach out to us at practicesupport@wakehealth.edu.

We’re excited to invite you to the last Community Health Worker (CHW) Integration Workgroup meeting of the year on:

📅 Date: Tuesday, December 9, 2025
🕑 Time: 2:00 – 3:00 p.m.
📍 Location: Virtual (Zoom)

This session will feature El Futuro, sharing their experience implementing the Collaborative Care Model (CoCM) program with CHWs. It’s a great opportunity to learn from their journey and explore strategies for integrating CHWs into care teams.

Join Zoom Meeting:
https://us02web.zoom.us/j/89721245320?pwd=vZahdMsTNgYvfumrx08NsjzpnFPyKn.1
Meeting ID: 897 2124 5320
Passcode: 758973

Questions Contact Jessica Rodriguez at jessica.rodriguez@mahec.net.

Looking Ahead to 2026

This workgroup series will continue next year, highlighting CHW integration efforts across the state. Stay tuned for more opportunities to connect, share, and learn!

Are you a new or aspiring practice manager, or a provider interested in learning more about practice management? The NC AHEC Practice Management Academy is your gateway to professional growth, networking, and leadership development.

Practice Manager Boot Camp: Leadership Module

Spaces are still available for the Leadership module, starting January 2026!

• Dates: Thursday, January 8, 2026 – Monday, March 9, 2026
• Time: 3:00 PM – 4:00 PM
• Format: Virtual Classes (9 Contact Hours)
• Registration: https://www.southernregionalahec.org/courses-and-events/75763
• Registration closes: January 7, 2026
• Fee: Register by 12/8: $180 | After 12/8: $225

Who Should Attend?

• New and aspiring practice managers
• Providers interested in practice management
• Anyone seeking to enhance leadership and management skills

What You’ll Learn

Week-by-week topics include:

• Braveheart Leadership: Characteristics of inspirational leaders, personal strengths and growth opportunities
• Becoming an Authentic Leader: Impact of gender and implicit bias, authentic leadership styles
• Understanding & Building Your Team: Emotional intelligence (EQ) vs. intelligence quotient (IQ), team dynamics
• Vampires in the Workplace: Identifying and managing toxic staff
• Effective Communication: Professionalism, conflict cycles, and resolution
• Managing Conflict: Power dynamics, critical conversations, crisis communication
• Retaining Effective Employees: Creating a constructive work environment
• Mentoring Physician Leadership: Strategies for orienting provider-leaders, collaboration
• How to Run a Meeting: Structured agendas, facilitation, best practices, and formal meeting structures

Speakers

• GeGe Beall (MS, FACHE, SPHR, SHRM-SCP): Expert in industrial/organizational psychology and HR/organizational development
• Matt Johnson (BA, MA, MBA): Experienced practice administrator, NC Medical Group Management Association board member
• Jane Moran (BA, MLS): Project Specialist, NCAHEC Practice Management Academy, customer service and education expert
• Melissa Overton (BSN, RN, CEO): Award-winning educator, mentor, and CEO of MedicalTraining.me

Why Join the Practice Management Academy Community?

• Free Membership: Access free courses, news, and networking opportunities
• Professional Development: Learn and register for upcoming courses
• Networking: Connect with other practice managers and providers

As North Carolina moves into data-driven, value-based health care, the N.C. Health Information Exchange Authority is working to modernize the state-designated health information exchange, NC HealthConnex. This valuable tool can help your practice close important care gaps through information  exchange between health care provider and patient. The N.C. Health Information Exchange Authority is offering valuable training on the features of NC HealthConnex.

• Module 1: NC HealthConnex Overview — Watch this module.
  
  To access the rest of the training modules, please fill out the training request form.
• Module 2: Unpacking the NC HealthConnex Welcome Packet (12 minutes)
• Module 3: Participant Account Administrator Roles & Responsibilities (10 minutes)
• Module 4: Clinical Portal Overview (20 minutes)
• Module 5: Direct Secure Messaging
• Module 6: Patient Education (26 minutes)
• Module 7: NC*Notify (13 minutes)
  

   

From the CMS QPP Updates Newsletter:

From MLN Connects Newsletter, Special Edition: October 1, 2025:

What’s Changing with Medicare Telehealth?

1. Fewer Services Will Be Covered
   Many telehealth services that were allowed during the COVID-19 emergency will no longer be covered unless Congress acts. This mostly affects non-mental health services.

2. As prior to COVID -19 Flexibilities, Where the Patient Is Matters
   Patients must be in rural areas or certain medical facilities to get Medicare-covered telehealth (except for mental health care).
   Services from home will not be covered for most types of care.

3. Mental Health Services Are Still Covered
   Telehealth for mental and behavioral health can still be done from home.
   However, patients must have an in-person visit at least once every year to keep using telehealth for these services. 

4. Advance Notice May Be Needed
   If a provider offers a telehealth service that Medicare won’t pay for, they may need to give the patient an Advance Beneficiary Notice to explain the cost.

5. Some Providers Can Still Use Telehealth Freely
   Providers in Medicare Shared Savings Program ACOs can continue offering telehealth without location limits, even after October 1.

    

   Source: https://www.cms.gov/medicare/payment/fee-for-service-providers 

This edition of the newsletter was sent to subscribers on October 1.  You are encouraged to subscribe to updates from CMS. Archived editions of the newsletter are available here.

North Carolina Medicaid provider reimbursement rate reductions go into effect October 1, 2025.

The reduction percentages vary from 3%,  8% or 10% and apply to procedure codes.

NC Medicaid plans to publish detailed updated fee schedules to the NC Medicaid Covered Codes and Fee Schedules Portal. You are advised to check back frequently for these updated documents.