Defining the value of Care Management from the Users Perspective


With the onset of Care Management as the mechanism by which NC Medicaid will provide integrated, whole person care, i2i was able to bring together Medicaid users and key stakeholders to discuss and identify what user value as part of their Care Management experience.  Working under a grant, i2i convened and facilitated a Collaborative on this topic, developed recommendations for NC DHHS, PHPs, LME/MCOs, and Care Management Providers.  In addition, a Consumer Engagement Sheet was developed for Care Management staff, Medicaid users and Family Members to set the stage for a successful Care Management experience.  The project also led to national recognition for i2i’s Collaborative work.

i2i Project Skills:

  • Expertise in NC Medicaid Managed Care Transformation and Whole Person Care Policies
  • Creation of Nationally Recognized Equal Voice Collaborative Model
  • Ability to Convene Key Stakeholders and Leaders
  • Facilitation and Collaboration 
  • Consumer Engagement
  • Reporting and Recommendation Development
  • Statewide dissemination of System Products & Recommendations to State Leaders and Stakeholders

Nationally Recognized Collaborative Model – Videos

A Collaborative Approach to Consumer Engagement in NC

Consumer Engagement:  Leveling the Playing Field

Consumer Engagement:  Building Organizational Support


Project Details

In 2021, the i2i Center for Integrative Health and the NC Community Health Centers Association were awarded a one-year Delta Center for a Thriving Public Safety Net alumni grant related to value-based care.  Under this grant, i2i convened a Collaborative group to define, from the perspective of service users,  the value of care management as it is structured within Medicaid Transformation.  This Collaborative was able to consider care management in a larger context, as a role that is crucial to addressing racial and health equity issues and the pandemic. 

In December 2021, the Collaborative concluded its work with recommendations that are both broad and specific and do not just affect care management agencies, but cut across stakeholder lines as well, and should be reviewed and considered for implementation by Care Management Agencies, NC DHHS, LME/MCOs, PHPs and Advocates.  These recommendations are detailed  in a White Paper titled Defining the Value of Care Management for Consumers, Families and Individuals with Lived Experience in North Carolina:  A Collaborative Approach.  A Summary of the Recommendations is also available.

The Collaborative was able to define the value of care management to consumers and families by considering “What would make care management valuable and successful from the perspective of the consumer and family?”  The collaborative looked and made substantive recommendations that address:  the comprehensive assessment process, racial and health equity questions, data integration and outcomes and the care manager training and qualifications.  As a result, a Consumer-Care Manager Engagement Sheet was created.  This sheet is designed to be used by consumers and family members to create a dynamic discussion with their Care Manager during the initial assessment and to initiate a dynamic relationship that includes trust and strong communication.  The critical importance of this dynamic is to ensure success, as defined by the consumer, in services and supports which then increases the value of the services.

The Consumer-Care Manager Engagement Sheet is a FREE resource that i2i encourages all groups—especially organizations that benefit consumers—to distribute widely and share as appropriate.

i2i Equal Voice Collaborative Model

Another positive result of this work has been the creation and piloting of a new collaborative model – i2i Equal Voice Collaborative Model, which can be replicated, and which brings consumers, families, persons with lived experience, advocates, and professionals to the same table with an understanding and focus on the equal value of each perspective.

The i2i Equal Voice Collaborative Model is receiving national recognition by the Delta Center.  The Delta Center for a Thriving Safety Net produced three videos that describe the i2i Equal Voice Collaborative Model process and lessons learned from the participants. Video 1 focuses on the Collaborative as a whole. Video 2 addresses important aspects of the engagement process, consumer participation, and leveling the playing field; and the Video 3 discusses the importance of rethinking how organizations engage with consumers and build trust.

Collaborative Model Facilitation

i2i is available to facilitate the use of the i2i Equal Voice Collaborative Model to resolve complex issues for your organization and its stakeholders.  Contact Ann Rodriguez at (919) 744-7937 or email .

Collaborative Members included:

  • 7 Consumer/Family members familiar with the LME/MCO system
  • 7 Consumer/Family members who serve on FQHC/CHC boards
  • 3 providers within the LME/MCO system
  • 3 providers within the FQHC/CHC system
  • Ad Hoc representation from NC DHHS.

Collaborative Products

Consumer and Family Member Collaborative Recommendations on Care Management Summary

Consumer – Care Manager Engagement Sheet

White PaperDefining the Value of Care Management for Consumers, Families and Individuals with Lived Experience in North Carolina:  A Collaborative Approach.

Delta Center – NC Collaborative Spotlight 

Delta Center Key Lessons on Meaningful Consumer and Family Engagement from North Carolina


Handout from webinar given to Collaborative Members by NC DHHS staff on Tailored Care Management:  Overview of the AMH+ and CMA Model

Alternative Payment Model Framework Fact Sheet

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

Advocacy 101 Presentation

Article February 28, 2021 Healthy Opportunities Pilots to Further Whole Person Care


i2i Care Management Articles:

RFA Pre-Release Spells Out Requirements For BH/IDD Tailored Plans March 12, 2020

Transition Of Care Across Medicaid Plans Detailed In Concept Paper March 1, 2020

Care Management: A Core Function In The BH/IDD Tailored Plan News Update 2/11/20

More Detail Released On Care Management In The Tailored Plans June 5, 2019

January 31, 2019 – Tailored Plan Care Management Becomes Clearer 

September 19, 2018 – Advanced Medical Home Resources Available 

August 15, 2018 – NC DHHS Puts More Meat On Medicaid Transformation Bones – Care Management/General 

We want to thank the Organizations that made donations to Support Consumer/Family Compensation to Participate in Collaborative


AmeriHealth Caritas

Carolina Complete Health

Healthy Blue NC


WellCare of North Carolina

Alliance Healthcare

Trillium Health Resources