MeckLINK: Parting Is Such Sweet Sorrow!…or…And Then There Were Nine…And Counting!

“Parting is such sweet sorrow, That I shall say good night till it be morrow.” Anyone know who said that famous line?  Juliet said it to Romeo (William Shakespeare) in Act II, Scene 2 of Romeo and Juliet.  Much different from Act 5, Scene 3 when Romeo commits suicide by poison when he believes his beloved Juliet is dead.

“Here’s to my love! (drinks the poison) O true apothecary, Thy drugs are quick. Thus with a kiss I die.”

Are we soon to part with MeckLINK Behavioral Health (“MeckLINK”)?

As of now, MeckLINK is one of 11 managed care organizations (MCOs) managing behavioral health care for Medicaid recipients in North Carolina.  We will say good-bye to Western Highlands September 30, 2013, so starting October, we will have 10 MCOs.

Is MeckLINK the next doomed MCO?  The next MCO to go poof!

According to the Charlotte Observer, Phil Endress, the CEO of MeckLINK, who was under fire a couple of weeks ago before the Mecklenburg county commissioners, has resigned, effective September 30, 2013.  Coincidental that Endress is resigning the day that Western Highlands is scheduled to disappear? Poof!

Mr. Endress appeared in North Carolina in August 2012 to run MeckLINK.  Since August 2012 (basically 1 year, give or take) Endress hired over 200 employees to run MeckLINK. (Talk about administrative burden).

So what happens to all the 200 employees hired by Endress when MeckLINK goes poof?  Who knows.  But, at least, Endress has a job.  He is moving to Jersey City, New Jersey, to become a director for a private mental health care company.  The 200 employees Endress hired? Well, he is not taking them with him.

What will become of mental health in Mecklenburg county?

Well, I know for many health care providers in Mecklenburg county parting will  NOT such sweet sorrow.  It will just be sweet. Recently, MeckLINK has terminated multiple provider agencies from its network (in our opinion without merit) and denied services for Medicaid recipients (in our opinion that are medically necessary).  But what will happen to Mecklenburg county Medicaid providers and recipients if MeckLINK goes poof?

Rumor has it that either Smokey Mountain Center or Alliance Behavioral Health will take over.

If Smokey takes over MeckLINK, Smokey will be, by far the largest MCO in North Carolina, geographically.   Smokey already covers:Serving individuals with mental health, developmental disability and substance abuse issues in Alexander, Alleghany, Ashe, Avery, Caldwell, Cherokee, Clay, Graham, Haywood, Jackson, Macon, McDowell, Swain, Watauga and Wilkes Counties

Add the 8 counties that Western Highlands is handing over to Smokey Sept. 30th and Mecklenburg county and Smokey would manage 24  of the 100 counties in North Carolina.  Whew! That’s a large jurisdiction.

If, on the other hand, Alliance takes over MeckLINK, then Alliance will not be the largest MCO in area, but, perhaps, the most Medicaid-funded and largest as to population-served.

Alliance currently manages Wake, Durham, Johnston and Cumberland counties.  Add Mecklenburg county and Alliance is in control of the most populated cities in North Carolina: Raleigh, Durham, Charlotte, Smithfield (ok, Smithfield is not that big, but it has outlets!), Fayetteville, Apex, Garner, Clayton…the most populous cities and towns in NC.

We started with 11 MCOs. We are down to 9.  The song “Another One Bites the Dust,” comes to mind. [Bum, bum, bum].

Remember, McCrory seems to want to run the number down to 3.

6 more to bite the dust?

“The McCrory administration envisions three or four competing private managed care organizations would deliver Medicaid services, replacing the monopolistic Community Care of North Carolina model now in place”

Parting is such sweet sorrow.

Thy drugs are quick. Thus I die with a kiss.

Are we all to end like Romeo?

Remember, we started the MCO system THIS YEAR. (Not counting Cardinal, which was the test-model prior to all MCOs  going live).  As in 9 months ago.  How scary is it that the whole MCO system (11 MCOs to manage behavioral health for Medicaid recipients) is unraveling to 9 within 9 months of inception.  Where will we be a year from now?

Maybe McCrory is right.  We will have 3-4 MCOs.

It’s like Darwin’s theory.  Survival of the fittest.

Western Highlands and MeckLINK were the weakest.  Who is next?  Eastpointe?  East Carolina Behavioral Health?  Time will tell.  And apparently time is fairly swift.  Like the poison drunk by Romeo, we may not have to wait long to see which MCOs survive and which MCOs fail.

If I were a betting man (which, obviously, I am not), I would go “all-in” on Alliance or Smokey.

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on September 18, 2013, in Alliance, Behavioral health, Denials of Medicaid Services, Division of Medical Assistance, EastPointe, ECBH, Health Care Providers and Services, MCO, MeckLINK, Media, Medicaid, Medicaid Recipients, Medicaid Services, Medical Necessity, Mental Health, Mental Health Problems, Mental Illness, NC DHHS, North Carolina, Provider Medicaid Contracts, Sandhills, Smokey Mountain Center, Termination of Medicaid Contract and tagged , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink. 14 Comments.

  1. MeckLink was denied initially by Mercer….”they weren’t ‘ready'”….MeckLink got an attorney, and threatened to sue (after hiring 130 new employees and spending $$$$ on a new IT system, so the state gave them the go-ahead to try to develop and take on their own MCO.
    Three days after they went “live”, Secty. Wos & our Governor came out with their plan for “integrated care”…..Who could NOT have possibly have seen the handwriting on the wall after THAT little fiasco…?

  2. At a recent CoastalCare meeting, it was announced that they were presenting to the state in November to merge with Eastpointe and ECBH.

    • Really? Was it memorialized?

      • It was announced at the Provider Council meeting (which I was not at) and the provider workgroup meeting that I was at. They aren’t trying to keep it a secret. I think up until now they were because they’ve been meeting since May supposedly. Now CC is openly asking about it.

  3. I have been in the MH/DD (IDD)/SA system for over 35 years….I have never seen this level of incompetence, nor the blatant display of hiring “campaign workers” as “highly qualified” individuals within DHHS (at 24 years old…? Give me a break….their brains are still in adolescence!) …..I am saddened by the break-down of MH services in NC, and am so angry at what this administration is doing to the most vulnerable of our state residents…..

  4. Centerpoint is considering merging with Partners and Smokey or Cardinal (see: ).

    Also, don’t forget before Mecklink threatened to file suit against the state, DHHS had turned management of Mecklink over to Cardinal this past January (see: ). So I think it’s a good bet that Cardinal will end up Managing Mecklink when this is all said and done. After all, they are planning to hire 150 new employees for the new center they plan to open (see: ), and it’s a good chance that the center will be in Charlotte.

  5. Yes, parting is such sweet sorrow! Do you think he can take the CEO of Alliance with him?

  6. I just want to say that I regret that Phillip Endress is leaving North Carolina, but I believe he has skills and history that our state can not appreciate or utilize with the current state of things. I met Mr. Endress years ago. What I know is that he has helped build strong area systems in New York and that he had a far more integrative perspective of the role of persons who have lived experience with mental health problems, substance use disorders, and other disabilities in strengthening systems so they will yield better personal outcomes for their intended beneficiaries. I have friends who are advocates for recovery outcomes in New York who feel he is a great guy and a very effective administrator.

    Phil will be able to use his strengths better in another state than in ours just now. But his departure is just another indicator that we will have to advocate very hard through all the changes and until the dust settles somewhat in NC before we can support the strengths of a leader like Phil.

  7. I’m a big fan of competition. Competition would require that there be overlap in the regions served and not an exclusive contract given for each region.

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