The Merger of the MCOs!

Breaking News: From DHHS

Raleigh, NC

State health officials announced today that the state- and Medicaid-funded Local Management Entities/Managed Care Organizations providing mental health, intellectual and developmental disability and substance use services to North Carolina citizens will be consolidating into four service regions across the state.

Further consolidation will improve quality of services, accessibility, accountability and long-term sustainability.

“I’m a strong believer in LME/MCOs,” said Rick Brajer, Secretary of the Department of Health and Human Services. “These populations deserve dedicated management.”

The newly consolidated service areas are:

  • North Central Region: CenterPoint Human Services and Cardinal Innovations Healthcare Solutions will be merging
  • South Central Region: Sandhills Center and Alliance Behavioral Healthcare will be merging
  • Eastern Region: Eastpointe and Trillium Health Resources will be merging
  • Western Region: Partners Behavioral Health Management and Smoky Mountain LME/MCO will be merging

newmco

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on March 18, 2016, in "Single State Agency", 1915 b/c Waiver, Access to Care, Alliance, Behavioral health, Cardinal Innovations, CenterPoint, Certification of MCOs, DHHS, EastPointe, ECBH, Gordon & Rees, Health Care Providers and Services, Knicole Emanuel, Legislation, Local Management Entity, Managed Care, MCO, MeckLINK, Medicaid, Medicaid Attorney, Medicaid Providers, Medicaid Reimbursements, Mental Health, Mental Health Problems, Mental Illness, NC, North Carolina, Partners, Rick Brajer, Sandhills and tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink. 10 Comments.

  1. Knicole, do we yet have a breakdown of the projected cost savings of these mergers? In other words, do we know how much money will be saved on duplicative positions and processes which can then be directed towards needed services for consumers?

  2. When will this be implemented?

  3. Centerpoint merging with Cardinal is supposed to be between May 1 and June 30th this year. I think the other MCO’s are supposed to present their timelines later this year.

  4. Does this mean a provider that is in one network will be in all of the networks in that region.

    • Good question, Khill. You never know whether an MCO will accept the providers in other networks. I suggest prepare for the worst and hope for the best. Be ready to take legal action, if necessary.

  5. Kimberly Grady

    When the MCOs merge, will one MCO be more dominant than the other? For example, when Coastal Care and ECBH merged together, ECBH took the lead. Do you have any idea who will “take the lead” with the upcoming mergers?

    • Good question, Kimberly. I am sure that one will be more dominant. I am sure there is internal fighting as we speak. My guess is whichever MCO is bigger at the time, but my guess is as good as yours.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: