December 16, 2020

0i2i to convene consumers to define value of care management for individuals and families

The Delta Center for a Thriving Public Safety Net has awarded the i2i Center for Integrative Health and the NC Community Health Centers Association (NCCHCA) a one-year grant.  The grant will allow i2i and NCCHCA to work with consumers, providers and payors to define the value of care management

Under this grant, i2i along with NCCHCA will convene a collaborative of 20 individuals, comprised of 14 consumers and 6 providers (payors will also be consulted).  The Department of Health Benefits will also participate in the group as final recommendations will be provided to NC DHHS with the hope of shaping how care management is carried out under both the Standard Plan and Tailored Plans.  The purpose of the group will be to define what consumers want from their care manager and the Care Management function in NC’s managed care system.  The care management role in the vision for NC’s public health and human services system is a centerpiece to ensuring integrated care.  It is the Care Management agency’s responsibility to 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 sees as most important in this role will be key to its success. 

Every member of a BH/IDD Tailored Plan will be assigned a care manager.  NC DHHS has published a guidance document and requested letters of intent from those organizations, either Tier 3 Advanced Medical Homes (AMH) or BH/IDD/SUD providers, that are interested in becoming certified BH/IDD Tailored Plan care managers.  NC DHHS has also provided a “glide path” that will shift the majority of the care management role from the LME/MCOs to community-based organizations over the course of several years. For more information on Care Management, see i2i article.

The grant collaboration with NCCHCA and its members will also be critical as their members are Federally Qualified Health Centers (FQHCs) and Community Health Centers which already provide some integrated physical and behavioral healthcare.  As such, many of NCCHCA’s members are working to become Tier 3 AMH that will provide care management under the Standard Plan and some may also become certified as the AMH+ care managers under the BH/IDD Tailored Plan.  In addition, 51% of the FQHC board is made up of consumers. 

i2i and NCCHCA are currently developing a timeline and a representative perspective mix for the collaborative process.  The goal is to begin the collaborative discussions in early 2021. 

i2i and NCCHCA just completed a two-year grant through the Delta Center to progress value-based care in North Carolina through education and collaboration.  This new grant was only available to those “alumni” of the original grant.