Medicaid Transformation

Medicaid Transformation

Transformation Brings Integrated Care to Medicaid

August 18, 2021

North Carolina’s move to establish a Medicaid system that provides for integrated, whole person physical and MH/IDD/SUD care as well as opportunities to address non-medical drivers of health/social determinants of health finally began on July 1.  It has been a lot of work and a long time coming.  In 2016, NC DHHS received approval from…

Medicaid Transformation

BH/IDD Tailored Plan Contracts Awarded and Potential PHP Partners

NC DHHS announced on July 26th that all seven of the current LME/MCOs received the awards to become BH/IDD Tailored Plans beginning on July 1, 2022.  This will shift to six Tailored Plans assuming the merger between Cardinal Innovations and Vaya Health progress as well as the other county disengagements that are underway.  In this…

Legislation

Numerous Bills Could Positively Impact Services

May 18, 2021

We are five months into the Long Session of the NC General Assembly (NCGA).  Usually that means that we have already seen a budget proposal, but not this year. There have been many, many new bills introduced, so many of which could affect our service system in a positive way.   There has been an…

Announcements

i2i Supporting the Quality Strategy – NC’s Opportunity to Improve Care

A message from the i2i Center Executive Director Ann Rodriguez This started as an informational article about the Quality Strategy for North Carolina’s Medicaid Transformation.  But I realized that what I most wanted to achieve with this article is to compel readers to become active in the formulation of the Quality Strategy.  With an article,…

Medicaid Transformation

Medicaid Open Enrollment Wraps Up for Standard Plan – What Now?

Open enrollment for a Medicaid Managed Care began March 15 and ended May 14th, giving Medicaid recipients two months to choose the Pre-Paid Health Plan (PHP) they want as their insurance program under new Medicaid Standard Plan that will begin on July 1.  For those who did not proactively choose a Standard Plan, NC DHHS…

Medicaid Transformation

Medicaid Managed Care Enrollment Information

April 30, 2021

NC DHHS has just released some helpful information for individuals receiving Medicaid that will be affected by the transition to managed care July 1 to help them understand whether or not they need to choose a new Health Plan right now – Do I need to Choose a Health Plan Fact Sheet The Fact Sheet…

Medicaid Transformation

Medicaid Transformation Begins as Open Enrollment Goes Live

March 23, 2021

Moving to Medicaid managed care has been a roller coaster ride in North Carolina.  There have been budget impasses, postponements and lawsuits.  All of those challenges seem to have been overcome.  The money has been appropriated to get started.  Standard Plan members are currently in an open enrollment period to choose their Prepaid Health Plans…

Medicaid Transformation

BH/IDD Tailored Plan Care Management a Work in Progress

The care management function under the BH/IDD Tailored Plan (Tailored Plan) appears to be evolving.  The care management function under the Standard Plan and BH/IDD Tailored Plan have significant differences in requirements based on the needs of the members of these plans.  An initial difference is that an Advanced Medical Home under the Standard Plan…