AmeriHealth Caritas Announces Agreement with the Advancing NC Whole Health Coalition for Medicaid Transformation In North Carolina
AmeriHealth Caritas, a national leader in Medicaid managed care and other health care solutions for those most in need, announced it has signed a letter of agreement with the three individual members of the Advancing NC Whole Health Coalition to develop integrated care solutions for North Carolina Medicaid enrollees under the state’s Medicaid Transformation plan. The Advancing NC Whole Health Coalition is a partnership of three high-performing North Carolina local management entities/ managed care organizations — Alliance Behavioral Healthcare, Trillium Health Resources, and Vaya Health.
AmeriHealth Caritas’ recognized expertise in managed care is centered on a member-focused approach that examines the social determinants that impact an individual’s health. This holistic model addresses issues such as food insecurity, job opportunities and education through community-based programs and integrated care management connecting behavioral health, physical health, and pharmacy.
"The relationship between the Advancing NC Whole Health Coalition and AmeriHealth Caritas combines the strengths of the Coalition’s community-based behavioral health care with AmeriHealth Caritas’ best practices for delivering managed care across the nation," said AmeriHealth Caritas Chairman and CEO Paul Tufano. "Our organizations care deeply about achieving the highest quality care for North Carolina Medicaid recipients and delivering the state’s desired outcomes."
AmeriHealth Caritas will seek to win a Standard Benefit Plan contract in response to the state’s recent request for proposals for Medicaid managed care prepaid health plans (PHPs). The State has indicated that it intends to award up to four contracts with PHPs to offer Standard Benefit Plans, which are Medicaid Managed Care plans that will serve most North Carolina Medicaid and NC Health Choice beneficiaries, including adults and children. These Standard Benefit Plans will provide integrated physical health, behavioral health, and pharmacy services under North Carolina’s Medicaid Transformation that is expected to launch in the second half of 2019.
Under their agreement, the Advancing NC Whole Health Coalition will provide certain functions necessary to help AmeriHealth Caritas build and grow a successful Medicaid health plan in North Carolina. This solution will combine AmeriHealth Caritas’ 35 years of experience in Medicaid managed care across the country with the Coalition’s expertise in managing behavioral health and intellectual and developmental disabilities services for more than 715,000 Medicaid eligible individuals across 53 counties in the state.
AmeriHealth Caritas currently provides full-risk Medicaid managed care in Delaware, Florida, Louisiana, Michigan, Pennsylvania, South Carolina, and the District of Columbia. In a number of those markets, an AmeriHealth Caritas member company was an inaugural health plan under the state’s Medicaid managed care program.
A joint statement released by Coalition CEOs Rob Robinson, Leza Wainwright and Brian Ingraham stated, “As mission-focused organizations offering targeted programs for Medicaid-eligible individuals in our various regions, we share a vision of how effective integration of physical and behavioral health can help deliver positive outcomes for our members. Combining a track record of proven experience and complementary competencies with a shared mission to serve complex, at-risk populations will ensure the best possible foundation to exceed the goals of NC Medicaid Transformation. We look forward to collaborating with AmeriHealth Caritas to help Medicaid members in North Carolina get care, stay well and build healthy communities.”
About the Advancing NC Whole Health 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 over 715,000 Medicaid covered lives across 53 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 2,200 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 26 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 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.