N.C. Medicaid Chooses Organizations for Integrated Behavioral Health Plans
The North Carolina Department of Health and Human Services has chosen seven organizations to serve as the initial Behavioral Health and Intellectual/Developmental Disability Tailored Plans starting in July 2022.
Behavioral Health I/DD Tailored Plans will provide integrated physical health, behavioral health, long-term care, and pharmacy services and will address unmet health-related resource needs for qualifying North Carolinians under one plan. These plans will provide the same services as NC Medicaid Standard Plans with additional specialized services to serve individuals with significant behavioral health conditions.
Individuals who need certain services to address a serious mental illness, serious emotional disturbance, severe substance use disorder, intellectual/developmental disability or traumatic brain injury may be eligible to enroll in a Behavioral Health I/DD Tailored Plan.
Following a competitive selection process, the following organizations were awarded a contract to serve as regional Behavioral Health I/DD Tailored Plans:
• Alliance Health
• Eastpointe
• Partners Health Management
• Sandhills Center
• Trillium Health Resources
• Vaya Health
• Cardinal Innovations Healthcare
The North Carolina Department of Health and Human Services (NCDHHS) said that although Cardinal Innovation Healthcare was awarded a contract, it is anticipated they will not operate a Behavioral Health I/DD Tailored Plan at launch due to a consolidation with Vaya Health.
“NCDHHS looks forward to working with the awardees to make this innovative design a reality for the thousands of North Carolinians who will benefit from a whole person-centered, well-coordinated system of care," said NCDHHS Secretary Mandy K. Cohen, M.D., in a statement. “Today moves us closer to that goal as we begin to implement this important program design.”
At launch, Behavioral Health I/DD Tailored Plans will operate regionally, offering care management to approximately 200,000 individuals estimated to enroll.
The first Behavioral Health I/DD Tailored Plans contract term will last four years. The Department has the authority to award no more than seven and no fewer than five regional Behavioral Health I/DD Tailored Plan contracts and may not award any statewide contracts.
St. Louis-based Centene Corp. (NYSE: CNC), the largest Medicaid managed care organization in the country, announced that its North Carolina subsidiary, Carolina Complete Health, a provider-led health plan established in partnership with the North Carolina Medical Society and working in conjunction with the North Carolina Community Health Center Association, will help coordinate integrated care for Partners Health Management and Trillium Health Resources.
"We are honored and excited to work with these strong local organizations, Partners and Trillium," said Chris Paterson, CEO of Carolina Complete Health, in a statement. "We believe healthcare is best delivered locally, and through these partnerships, we further our ability to provide high-quality, coordinated care in North Carolina. We look forward to joining Trillium and Partners in advancing this innovative model of care in North Carolina."
On July 1, North Carolina launched a major transition to Medicaid manage care, which will impact how millions of North Carolinians receive care. Among the goals are improving access to preventive health and wellness programs and driving down long-term healthcare costs. Under Medicaid Managed Care, Standard Plans and the Eastern Band of Cherokee Indians (EBCI) Tribal Option launched on July 1, 2021, followed by Tailored Plans on July 1, 2022.
The NCDHHS has selected three regions of the state to pilot a systematic approach to integrating and financing non-medical services that address housing stability, transportation access, food security and interpersonal safety into the delivery of healthcare for Medicaid beneficiaries.
The state said the regional pilot projects will mark the nation’s first comprehensive program to test evidence-based, non-medical interventions designed to reduce costs and improve the health of Medicaid beneficiaries. The regions chosen include two in eastern North Carolina and one in western North Carolina.
