N.C. managed care organizations announce coalition

Press release from Vaya Health: 

Leaders of three North Carolina managed care organizations (MCOs) announced a new partnership to leverage strengths and expertise in response to Medicaid reform. The coalition will unite the efforts of three high-performing MCOs—Alliance Behavioral Healthcare, Trillium Health Resources, and Vaya Health—to address significant, statewide health policy issues that impact North Carolinians across the state. The coalition is in full alignment with the Medicaid Reform plan proposed by the NC Department of Health and Human Services.

The joint effort is not a merger or mandated consolidation. Each of the MCOs will continue to operate in their respective counties, keeping their names, board structure and staffing, in addition to working together as part of the coalition to leverage resources, experience and expertise on a statewide level. MCO leaders identify the collaboration as the most effective way to demonstrate to NC DHHS, the General Assembly and potential commercial healthcare partners that MCOs can successfully implement Medicaid Transformation in a way that advances high-quality care, improves population health, engages and supports providers and establishes a sustainable program with predictable costs (a four-prong approach known as the Quadruple Aim).

Through the formation of the coalition, the MCOs seek to have a stronger voice in preserving the role of the public behavioral healthcare system in Medicaid Transformation, helping ensure continued stability and continuity of care for the people they serve. The potential to establish a combined statewide provider network will enhance access to a diverse range of services and supports for people in both urban and rural areas of the state.

“The public MCO system has unique experience and expertise in addressing the behavioral health needs of North Carolinians,” said Brian Ingraham, Vaya Health CEO. “This coalition provides an opportunity to build on our track record of success and expand our contribution to the health of the people we serve.”

“Trillium Health Resources believes that this closer collaboration with our colleagues at Alliance and Vaya will allow us to better serve our members, regardless of where they live in NC, and will promote a stable environment for our provider partners,” said Leza Wainwright, Trillium Health Resources CEO.

“Alliance has a proven history of effectively serving individuals with multiple and complex needs through evidence based practices, community partnerships and a focus on the social determinants of health – the environmental factors that impact peoples’ health and quality of life,” said Rob Robinson, Alliance CEO. “We are uniquely positioned to advance innovative, whole-person care as North Carolina transforms its Medicaid program, and this coalition will strengthen our ability to positively impact service delivery on a statewide basis.”

The formation of the coalition does not affect the services and supports of any members of Vaya, Trillium and Alliance Medicaid health plans. Members who have questions should contact their MCO through the respective Access to Care lines.

About the Coalition

Alliance Behavioral Healthcare, Trillium Health Resources and Vaya Health are local management entity/ managed care organizations (LME/MCOs) responsible for managing publicly-funded behavioral health and IDD services in three catchment areas that collectively span the State of North Carolina from the mountains to the sea. Together, they are responsible for managing more than $1.375 billion in public funds and 610,000 Medicaid covered lives across 52 counties. More information about the coalition can be found at www.advancingncwholehealth.com.

About Alliance Behavioral Healthcare

Alliance Behavioral Healthcare is the managed care organization for publicly-funded behavioral healthcare services for the people of Durham, Wake, Cumberland and Johnston counties. Alliance works with a network of almost 2200 private providers to serve the needs of 471,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million. Alliance operates an Access and Information Center available 24/7 at (800) 510-9132. Learn more at www.AllianceBHC.org.

About Trillium Health Resources

Trillium Health Resources is a leading specialty care manager (LME/MCO) for individuals with substance use, mental illness and intellectual/developmental disabilities in 25 counties in eastern North Carolina. Trillium’s mission is to transform the lives of people in need by providing them with ready access to quality care. We take a person-centered approach to health and wellbeing, coordinating care across multiple systems to achieve improved health outcomes, quality of care and efficient use of resources. Trillium is investing in innovation to meet the unique needs of the individuals and communities we serve, and remains focused on delivering the right services, in the right amount, at the right time. For more information, visit www.TrilliumHealthResources.org.

About Vaya Health

Based in Asheville, N.C., Vaya Health manages public funds for mental health, substance use disorder and intellectual or developmental disability services in 23 western North Carolina counties: Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Watauga, Wilkes and Yancey. Access to care and crisis assistance are available 24/7 at 1-800-849-6127. Learn more at www.VayaHealth.com.

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