N.C. Clinically Integrated Network Focuses on Underserved Populations

A clinically integrated network (CIN) is developing in North Carolina dedicated to strengthening the clinical, operational, and financial capacity of behavioral health and intellectual/developmental disability (I/DD) providers across the state.

With a focus on underserved populations, Charlotte-based Element by Arkhe Consortium Health is partnering with small provider organizations to provide technology services and analytics to help improve outcomes and drive value-based care across North Carolina, explained CEO Shaun Cox in an interview with Healthcare Innovation. 

“We started with behavioral health, IDD and SUD [substance use disorder] providers. That was the immediate need as we were going into the value-based care space,” Cox said. “But we have also started working with primary care providers who have integrated practices, and even primary care providers who wanted to start providing SUD services and behavioral health services.”

"Currently, we are covering from 20,000 to 25,000 covered lives throughout the state of North Carolina. The initial goal is to come together for value- based care, which is something new in the behavioral health space, so it requires some education,” Cox said. “And it's not an easy lift, especially for small providers who don't have a lot of time or a lot of resources.”

Element has partnered with Siftwell, a healthcare data analytics company. Siftwell assists population health and quality, risk adjustment and marketing teams in prioritizing outreach and interventions for members who require it the most. The company’s customers include Mountain Health CO-OP and Alliance Health.

By integrating Siftwell’s demographic analytics with Element’s care delivery infrastructure — including coaching, training, and education programs —the partnership unifies social determinants of health and claims data from managed care organizations within a single technology ecosystem. Element and Siftwell say this approach empowers providers with a holistic view of member needs, enabling them to identify members, determine the most effective interventions, and coordinate resources efficiently – particularly in addressing behavioral, maternal/prenatal, and racial health disparities across the state.

“We're working with some of the managed care organizations and working with Shaun and then on down to the individual providers,” said Siftwell CEO Trey Sutten. “What that enables us to do is have a comprehensive view of Element's members in the areas where those providers may not be directly providing care.”

Sutten said to imagine a scenario where you're a provider, and you know that you've done some therapy work with an individual, but you have no idea what's happening with their medications or how many times they've been to the emergency department. “What we're essentially doing is creating a 360-degree view of medical, pharma, behavioral and then on top of that, the social determinants of health. Where are they in the state? What is their access to transportation or food? What are the languages spoken? It's really a cool thing where the people on the front lines, by way of Shaun and her organization, are interacting with people with a much higher level of intelligence regarding their living situation, as well as the full complement of supports and services or interventions that they're receiving,” he added. 

Cox said her team is working with care teams who have been providing services in their industry for 20 to 30 years. “We want to make sure that they're able to survive this change to value-based care,” she said. “Now they're going to be able to have a voice to negotiate contracts. We're going to be able to tell our own story about what it looks like when people who  look like you provide services to you. They are going from left out to leading.”