History of Medicaid Transformation
In 2015, The North Carolina General Assembly (NCGA) established Medicaid Transformation for the following reasons: improved population health, improved coordination of care, improved access to resources that affect health, and cost reduction.
NCGA established two types of Health Plans for Medicaid recipients; Standard Plans for the largest portion of Medicaid recipients, and Tailored Plans for people with IDD, TBI, SPMI, SUD who have the need for more intense, or “tailored” services and supports.
In July 2021, the Standard Plans launched and Tailored Plans will launch July 1, 2024.
LATEST INFORMATION
The Tailored Plans will launch on July 1, 2024.
View our latest webinars on Tailored Plans below or by visiting our YouTube Channel.
The Arc of North Carolina continues to host webinars on Medicaid Transformation.
These webinars will have current updates with information you need to know.
TAILORED PLAN TO-DO LIST
Here is a to-do list you can use to assist in this choice period.
Helpful definitions:
–Tailored Plan/TP – essentially, the insurance company that authorizes all the services your loved one who has Medicaid might need when they have IDD (or serious mental health issues, substance use issues, or Traumatic Brain Injury). There are 4: Trillium, Vaya, Alliance, Partners. You will know these entities in the past as LMEs or LME/MCOs. Tailored Plans will launch July 1, 2024.
-Tailored Care Management/TCM– forget the ‘tailored’ and just think Care Management. This is your team captain, so to speak, and this person can help you coordinate ALL your physical and behavioral health services. See our info on it here and remember you have a choice in what Care Management Agency provides this service to you (if you didn’t pick one yourself, you were assigned to one, but you can pick a different one if you are unhappy). This service has been around since December of 2022.
DOWNLOAD A PDF VERSION OF THIS TO-DO LIST
Watch our Medicaid Transformation Webinar Series
These webinars are designed to help you better understand the transition to Tailored Plans and the launch of care management.
ADDITIONAL RESOURCES:
