Medicaid Transformation

Medicaid Transformation

Embedding State-Funded BH/IDD Services into Tailored Plans and More

February 4, 2020

The concept paper on State-funded BH/IDD services lays out a plan of action to create a more statewide, standardized approach to State funding. The paper indicates the State’s intent to move to a centralized decision-making process for eligibility, as reflected in the emphasis on the statewide structure described below. In addition to state funded services,…

Medicaid Transformation

Care Management: A Core Function in the BH/IDD Tailored Plan

NEWS UPDATE 2/11/20 Since the publication of the article below on the BH/IDD Tailored Plan Care Management application process NC DHHS has announced an extension before they begin the application process.  Originally they were to begin the first round of applications for Advanced Medical Home Plus practices and Care Management Agencies in February 2020.  That…

Medicaid Transformation

NC DHHS Expands on their Value-Based Payment (VBP) Strategy and Introduces the Medicaid Accountable Care Organization Model

The recently published concept paper, “North Carolina’s VBP Strategy for Standard Plans and Providers in Medicaid Managed Care” provides a lot of detail on strategies NC DHHS will employ to support the expanding use of value-based payment (VBP).  While their support strategies are optional, the paper also details the State’s contractual expectations for Prepaid Health…

Medicaid Transformation

Embedding State-Funded BH/IDD Services into Tailored Plans and More

January 24, 2020

The concept paper on State-funded BH/IDD services lays out a plan of action to create a more statewide, standardized approach to State funding. The paper indicates the State’s intent to move to a centralized decision-making process for eligibility, as reflected in the emphasis on the statewide structure described below. In addition to state funded services,…

Medicaid Transformation

NC Design for State Funded Services under the Tailored Plan

January 14, 2020

While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department continues to work on the design of Tailored Plans to serve individuals with behavioral health and intellectual disabilities in lieu of Standard Plans. In addition to managing Medicaid services, Behavioral Health I/DD Tailored Plans also will be…

Medicaid Transformation

Policy on Medicaid Accountable Care Organizations for the Medicaid Standard Plan and Providers

This paper released on January 8th, provides details on an optional Medicaid ACO program, including ACO organizational requirements, payment parameters, total cost of care calculation and participation incentives for early adopters. PHPs and providers can form ACO arrangements as a way to promote value in Medicaid and meet the Department’s VBP targets. The Department welcomes…

Medicaid Transformation

Policy on Value Based Payment Strategy for Medicaid Managed Care

This paper (released January 8th) describes the vision for value-based payments between Prepaid Health Plans and providers in NC Medicaid Managed Care. The Department welcomes feedback on this paper at Medicaid.Transformation@dhhs.nc.gov by Feb. 19, 2020. i2i is developing a Medicaid Transformation summary document on this information.

Medicaid Transformation

Update on Medicaid Transformation

November 21, 2019

On November 19th, NC DHHS released a statement that Medicaid Transformation has been suspended until the budget impasse is resolved.  A few points related to the suspension: There is NO IMPACT on Medicaid beneficiaries and their services.  All services will continue to be provided as they have been. Open enrollment is also suspended.  This means…