NCDHHS, Cherokee Indian Hospital Authority create nation’s first Indian Managed Care Entity

Press release from the N.C. Department of Health and Human Services:

The North Carolina Department of Health and Human Services and the Cherokee Indian Hospital Authority (CIHA) have entered into a contract to support the Eastern Band of Cherokee Indians (EBCI) in addressing the health needs of American Indian/Alaskan Native Medicaid beneficiaries.

This Indian Managed Care Entity is the first of its kind in the nation and will establish a new delivery system called the EBCI Tribal Option. The EBCI Tribal Option is a managed care option for federally recognized tribal members and other individuals eligible to receive Indian Health Services.

“This partnership is another example of how North Carolina is leading the nation with its innovative approach to managed care that focuses on meeting the needs of the whole person,” said NCDHHS Secretary Mandy K. Cohen, M.D. “The EBCI Tribal Option ensures American Indians in our state receive culturally competent care that improves overall health and wellbeing.”

The EBCI Tribal Option will manage the health care for North Carolina’s approximate 4,000 Tribal Medicaid beneficiaries primarily in Cherokee, Graham, Haywood, Jackson and Swain counties. The program will have a strong focus on primary care, preventive health, chronic disease management and providing care management for high-need members.

“As a Tribal Organization, CIHA is committed to improving the health of the American Indian/Alaskan Native Population by eliminating barriers to care and developing trusting relationships with our patients,” said Casey Cooper, Chief Executive Officer, CIHA. “With the support of NCDHHS, we will reduce health disparities while exercising our tribal sovereignty and self-determination.”

According to Cooper, the EBCI Tribal Option, like CIHA will be founded on principals such as U wa shv u da nv te lv (the one who gives from their heart) and Di qwa ste li I yu n(i) s di (like my own family to me), providing care coordination services in a culturally congruent system that leverages the collective strengths of a fully integrated health system, the Tribal community and regional partners.

Beginning in March 2021, Tribal members and people eligible to receive services at CIHA will have an opportunity to enroll in the EBCI Tribal Option and either keep their network primary care provider or select a different network primary care provider.

The EBCI Tribal Option is part of North Carolina’s transition to Medicaid Managed Care which will launch on July 1, 2021. In addition to the Tribal Option, Medicaid beneficiaries will be able to choose from five prepaid health plans — AmeriHealth Caritas, Healthy Blue, United HealthCare, WellCare and Carolina Complete Health (serving regions 3, 4, and 5). Some beneficiaries will remain in Medicaid’s Fee-For-Service program called NC Medicaid Direct.

NCDHHS and the EBCI will continue to share additional information on the EBCI Tribal Option to help inform beneficiaries and providers. Please visit https://medicaid.ncdhhs.gov for updates on Medicaid Managed Care or email Medicaid.Transformation@dhhs.nc.gov with additional questions.