Consolidation to Reshape NC Mental Health System

December 20, 2023. Two state-funded businesses that manage behavioral health services for low-income residents say they will consolidate to create a single organization to serve 46 counties across Eastern North Carolina.

Trillium Health Resources will take control of Eastpointe Human Services under the agreement, which was signed Saturday by the companies’ CEOs. The arrangement will reshape the state’s managed care system for providing care to Medicaid participants with mental health needs, substance use disorders and intellectual or developmental disabilities.

Eastpointe and Trillium are part of a network of six local management entities that operate as managed care organizations (known as LME-MCOs). That network oversees the treatment of those patients. A third such organization, the Sandhills Center, will dissolve in connection with the consolidation, leaving North Carolina with four LME-MCOs.

The consolidation flows from a directive issued in November by Sec. Kody Kinsley, head of the N.C. Department of Health and Human Services. He had been instructed by the General Assembly to reduce the state’s existing number of LME-MCOs to streamline the anticipated rollout of specialized plans for Medicaid participants who require more intensive services than typical beneficiaries.

DHHS has repeatedly delayed the implementation of these so-called tailored plans at the request of the LME-MCOs. Sandhills Center, in particular, struggled to secure tailored plan contracts with providers.

“Our goal is to get the tailored plan operators to a place where they can manage their patient population and the complex risks that they have in a smooth way,” Kinsley said in an interview Monday with NC Health News.

Continue reading this News article here.

Source: North Carolina Health News
Author: Jamie Baxley

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