Celebrating the Launch of Tailored Plans

The North Carolina Association of Public Community Health Plans (NCAPCHP) celebrates the launch of Tailored Plans on July 1, 2024. The launch of these new integrated health plans marks a significant milestone for our state, building on the strong foundation established by the Local Management Entity/Managed Care Organizations (LME/MCOs) over decades of managing specialized care and services for individuals with some of the most complex health needs across North Carolina.

Tailored Plans are designed to deliver comprehensive, whole-person care to Medicaid members who require specialized services for a serious mental health disorder, severe substance use disorder, intellectual/developmental disability, or traumatic brain injury. The implementation of Tailored Plans ensures that these individuals have access to a coordinated network of behavioral health, physical health, pharmacy, and long-term services and supports, and health-related resource needs. LME/MCOs will continue to serve members remaining in NC Medicaid Direct or who are uninsured with behavioral health services.

“Our four health plans are dedicated to supporting our members, families, and provider networks to ensure that Tailored Plans deliver on their promise of comprehensive whole-person care for those with complex needs,” said Rob Robinson, President of NCAPCHP and CEO of Alliance Health. “Together we are paving the way for the nearly 220,000 North Carolinians enrolled in Tailored Plans. Today is a big day and we look forward to the impactful work ahead improving the health and well-being of these members.”

Key features of the Tailored Plans include:

     

      • Tailored Care Management: Tailored Plans will provide a single point of contact for care management for seamless integration of physical health, behavioral health, and social services.

      • Person-Centered Planning: Each Tailored Plan member will receive a personalized care plan that reflects their unique needs, preferences, and goals.

      • Focus on Social Determinants of Health: Tailored Plans will address critical social factors such as housing, employment, and transportation, which are essential to overall health and well-being.

    Recognizing that a rollout of a new health plan involves challenges, NCAPCHP and its LME/MCO members are committed to working closely with Tailored Plan members and their families, our providers, health systems, and the North Carolina Department of Health and Human Services to ensure the successful delivery of high-quality, integrated care. Plan members and providers are encouraged to stay in communication with their LME/MCO and report any concerns to help optimize the service delivery.

    About the North Carolina Association of Public Community Health Plans

    The North Carolina Association of Public Community Health Plans (NCAPCHP) is dedicated to improving the health and well-being of North Carolina’s communities through advocacy, collaboration, and support for North Carolina’s four LME/MCOs – Alliance Health, Partners Health Management, Trillium Health Resources, and Vaya Health – and the members, families, and providers we serve. The NCAPCHP works with state/county/local agencies and policymakers, healthcare providers, and community stakeholders to ensure access to high-quality, equitable care for individuals with complex needs.

     

    For more information, please contact [email protected] or visit www.NCPublicHealthPlans.com.

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