RALEIGH, N.C. — A consultant examining options for overhauling Medicaid in North Carolina said Thursday it could be 2020 before any plan to stabilize costs and shift risk toward the private sector is implemented fully.

Bob Atlas spoke at the first meeting of an advisory panel charged by the legislature with advising the Department of Health and Human Services on what path to take on changing Medicaid, which covers more than 1.7 million North Carolina residents. The General Assembly wants a proposal from DHHS by mid-March, but would have to sign off later on any plan, which would be designed to make Medicaid funding more predictable while creating better patient outcomes.

Gov. Pat McCrory and department Secretary Dr. Aldona Wos unveiled a plan in the spring that envisioned three or four managed-care companies or other entities providing medical care and other services for Medicaid consumers in North Carolina. Medicaid would pay a flat amount to the provider for each patient it serves, rather than a fee for each medical service it performed as in the current system.

Many legislators and health care groups were skeptical of so extensive an overhaul, leading to the panel's creation. The administration also has stepped back somewhat from its original initiative as officials traveled the state seeking input.

Atlas and Mardy Peal, a senior adviser to Wos, told the more than 150 people attending the panel's meeting that any changes would be gradual.

"We do not believe that it is in the best interests of the state, beneficiaries or providers to rush this transition," Peal said. "We will therefore gradually implement changes to ensure providers have time to adapt to a new business model."

Atlas presented a potential alternative to panel members Thursday in which the state would be divided into six regions. A network of medical providers, an insurance company or some combination would enter into a contract to provide services to Medicaid patients in the region. Some panel members raised questions about the regional concept and potential challenges to being carried out.

Atlas told reporters later that the proposal was a starting point for panel members and interest groups to discuss a path forward.

The panel, led by former Moses Cone Health System CEO Dennis Barry, scheduled its next meeting for mid-January to receive public comment.