Daymark, a 501(c)3 sin-off from the early days of reform, has become the foot soldier for the LMEs/MCOs. Piedmont/Cardinal and Smoky send them in after a private/public provider goes under (whatever the reason). Daymark is everywhere. They are moving to be that single state-wide provider.
SMC in the early days of the Medicaid waiver put the “White Paper” on their web site, it may still be there, where SMC, Piedmont/Cardinal and East Carolina proposed to carve the state into 3 sections Western, Piedmont and Eastern and together they manage the behavioral healthcare for North Carolina. The Democratic Governor rejected such an axis of managed care, but this Republican Governor seems to be tacitly authorizing such a plan, the only change may be that Alliance is the 3rd axis member instead of East Carolina. “11,10, 9…3 open up pearlie gates ain’t got time to wonder why whoopi we are all going to lose behavioral healthcare”.. And the sound you hear are the boots on the ground of Daymark executing the Axis plan.