On Dec. 30, 2019, The Department of Health and Human Services issued a policy paper for public comment
While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department continues to work on the design of Tailored Plans to serve individuals with behavioral health and intellectual disabilities in lieu of Standard Plans. In addition to managing Medicaid services, Behavioral Health I/DD Tailored Plans also will be responsible for managing State-funded behavioral health, intellectual/developmental disability (I/DD), and traumatic brain injury (TBI) services as the Local Management Entities-Managed Care Organizations (LME-MCOs) do today for the uninsured, underinsured and Medicaid beneficiaries.
The Department welcomes feedback on both papers at Medicaid.Transformation@dhhs.nc.gov by Jan. 29, 2020.
On Jan. 8, 2020, the Department of Health and Human Services issued two policy papers for public comments detailing the strategy to promote value-based care in NC Medicaid Managed Care.
This paper describes the vision for value-based payments between Prepaid Health Plans and providers in NC Medicaid Managed Care.
This paper provides details on an optional Medicaid ACO program, including ACO organizational requirements, payment parameters, total cost of care calculation and participation incentives for early adopters. PHPs and providers can form ACO arrangements as a way to promote value in Medicaid and meet the Department’s VBP targets.
The Department welcomes feedback on both papers at Medicaid.Transformation@dhhs.nc.gov by Feb. 19, 2020.