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North Carolina's Medicaid Managed Care Services Propose Consolidation Plan to Increase Sustainability of North Carolina's Mental Health System


For Immediate Release
Tuesday, December 17, 2013

Raleigh, N.C. - Leadership of the 10 organizations responsible for the management of mental health, substance abuse and intellectual developmental disability services across North Carolina have notified Department of Health and Human Services Secretary Aldona Wos of their intent to consolidate into four regional local management entities-managed care organizations (LME-MCOs). The plan from the N.C. Council of Community Programs, which represents the LME-MCOs, specifies that the proposed system will have three main characteristics:

  • Four regions (1 Western, 2 Central, 1 Eastern);
  • Geographic contiguity (with the exception of existing MCO configurations); and
  • 300,000-350,000 covered lives per region.

"The consolidation to four LME-MCOs will help create a more sustainable behavioral health system while continuing to improve services through more efficient delivery of care," said Mary Hooper, Executive Director of the Council. "We are strongly committed to the McCrory administration's vision of a sustainable Medicaid program that has budget predictability and - most importantly - meets the needs of the people it is responsible for serving in the most integrated way possible."

Leaders of the LME-MCOs met with Secretary Wos during last week's NC Council of Community Programs conference in Pinehurst to share their proposal, which affirms the direction of consolidation set by the Department. In her remarks to providers, consumers and advocates assembled at the conference, the Secretary acknowledged the hard work of LME-MCO leadership over the past year and welcomed this plan and direction.

"We have set clear and high expectations for our LME-MCOs as they have matured this year, asking for more accountability, higher quality and a willingness to evolve by consolidating," Wos said. "They have truly stepped up and I appreciate their dedication to making our system stronger."

The attached map indicates the four regions proposed by the N.C. Council of Community Programs. Pending final approval of the plan, DHHS will work with the Council and LME-MCO leadership on a timeline for consolidation.

In 2011, the legislature created a plan to move the approximately two billion Medicaid dollars for mental health, intellectual and developmental disabilities, and substance abuse into a managed care system by July 1, 2013. This year, the McCrory Administration completed the task of moving the entire state into the managed care model.

This year, in addition to working towards this consolidation, DHHS also convened an internal workgroup to increase oversight over the behavioral health system and closely monitor financial and performance measures.

map of North Carolina showing proposed LME-MCO locations
Click here to enlarge the image.

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