Most of North Carolina’s Medicaid recipients have now moved over to managed care. Starting Thursday five statewide or regional health plans are handling care for roughly 1.6 million consumers covered by government health programs for poor children, older adults and others. Other patients will join next year. The managed care developers are hopeful it will mean improved health outcomes and cost controls. A 2015 state law put the wheels in motion for managed care. It was supposed to begin in 2019 but got delayed by a state budget impasse. North Carolina has been the largest state yet to switch to managed care.