May 18, 2021
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, I can’t say loud enough, “Hey! This is so important!”. Within the Quality Strategy are opportunities. Opportunity to imbed systemic mechanisms for consumer and family voice and involvement early and beyond individual treatment and supports planning. Opportunity for providers to have clarity about the quality and performance expectations in this transition. Opportunity for the public system to be strengthened and improved. Basically, if you believe that Medicaid Transformation needs to be more than a move to stabilize the budget, then the Quality Strategy is where you make your impact. I have high hopes that this move to Medicaid managed care, and really the larger goal of moving to integrated, whole person care, could be the best thing that has happened for the users of the public system since…ever.
What’s in the Quality Strategy?
Three (3) over-arching Aims are identified: 1) better care delivery; 2) healthier people, healthier communities; 3) smarter spending. All three of the broad aims cannot truly be achieved without the input and active participation of consumers and their families. The components of the strategy are where individuals can really weigh in on how it should be done, and they include:
The list above proves that the Quality Strategy is the powerhouse-packed gauge of success in managed care. NC DHHS updated the Quality Strategy paper in April 2021 and just closed the comment period. They have made a promise within the paper to have future opportunities for feedback, particularly early in the transition. I would urge everyone to use every chance for feedback so that what is important to you is included.
i2i Center is Supporting Quality Care
The i2i Center is creating opportunities and partnering in ways that support your participation in the ongoing assessment of quality care. We have four initiatives that are directly related to this effort:
1. The Delta Center for a Thriving Public Safety Net Alumni Grant that i2i has in partnership with the NC Community Health Centers Association, funds a collaborative conversation to Define the Value of Care Management. The collaborative consists of ten consumers, family members and individuals with lived experience and five providers who are working to become care managers. The focus of this group is to define what consumers want from their care manager and the Care Management function in NC’s managed care system. The care management role is a centerpiece to ensuring integrated care. The Care Management agency will coordinate behavioral health/IDD, physical health, pharmacy and social determinants of health for consumers and work with the Plan Managers to ensure individuals are receiving the right mix of care and services leading to whole person health. Care managers will interact directly with consumers to work with them on the medical and non-medical drivers (social determinants) of health; therefore, understanding what the consumer see as most important in this role will be key to its success. By October 31, 2021 i2i will have a set of principles, recommendations and other guidance to provide to NC DHHS leadership, legislators, PHPs and LME/MCOs on what consumers and family members want for their care management.
As part of i2i’s commitment to supporting participation for consumers and family members in the policy process, through generous support from a two LME/MCOs and each PHP, collaborative members who are not being reimbursed for their participation as part of their positions, will receive compensation from i2i.
2. The i2i Center has been assisting advocacy groups to strengthen their legislative and policymaking knowledge and skills. We use our knowledge in impacting the legislative process and policymaking to educate individuals with lived experience and individuals who serve as their natural supports. The goal is for them to know how and when to give their expertise and perspective early in the legislative and policymaking process. This is accomplished through regular updates on bills and policies that are most pertinent to the mission and helping formulate messaging and a plan of action for informing leaders of their position.
Most recently i2i provided a legislative update to State staff from the Division MH/DD/SAS, Social Services, Department of Public Instruction and Division of Juvenile Justice. This update gave them insight into bills that are supported by advocates and those that are of concern in order to better inform their work at the state level.
3. We are following up on the success of the virtual Pinehurst conference with the virtual Spring Conference 2021 3Cs of Transformation – Connect, Communicate, Collaborate on June 14-15. We have loaded the agenda with sessions related to the Quality Strategy components—Standard Plan and Tailored Plan implementation of the Quality strategy, population health, data metrics analysis, new technology for service delivery, coordination and communication with key community partners, value-based and whole health care.
4. And speaking of the conference, we are offering five scholarships to individuals with lived experience, family members and unaffiliated advocates through the generous donations made to the Mary Hooper Consumer Participation Fund. We were also able to provide a scholarship to a person with lived experience to attend the NC TIDE spring conference. These opportunities ensure that consumers and family members have access to the same learning experiences that professionals do.
We have a lot of hope for a more robust system through the NC DHHS vision for whole person care. i2i’s commitment to supporting these changes is strong and we are always seeking new projects and partnerships to advance integrated, whole person care