Transforming North Carolina with Tailored Care Management

Tailored Care Management: The Transformation in North Carolina

North Carolinians woke up on December 1, 2022 to a new kind of Care Management for individuals with intellectual and developmental disabilities (IDD) and behavioral health needs across the state.

MediSked served as the trusted partner for Trillium Health Resources, The Arc of North Carolina, and Monarch, followed soon after by Pivotal Health, part of Element by Arkhé Consortium Health LLC, in supplying a best-in-class solution.

Six Tailored Plans aligned with 69 CMA/AMH+ organizations across the state and began practicing conflict-free case management. But, what does that all mean?

A Tailored Plan is a health plan that offers services in physical health, pharmacy, care coordination and behavioral health services for individuals who have significant mental health needs, IDD, traumatic brain injury (TBI), or substance use disorders. Trillium Health Resources is one of six Tailored Plans in the state of North Carolina.

A Care Management Agency (CMA) provides Whole Care Management to individuals requiring support for Behavioral Health, IDD, and/or TBI. They can be aligned with one or more Tailored Plans. The Arc of North Carolina, Monarch, and Pivotal Health serve as CMAs.

An Advanced Medical Home Plus (or AMH+) is a primary care practice that provides specialized medical support and Care Management to Tailored Plan eligible members of the BH/IDD population.

Finally, a Clinically Integrated Network (CIN) allows multiple CMAs and/or AMH+ practices to align under a single entity to share resources and responsibilities to provide Tailored Care Management. Element by Arkhé Consortium Health LLC is one such organization, led by Pivotal Health.

What exactly is conflict-free case management? We go into more depth here, but in short, it prevents an entity from both providing care management and direct services supporting the same individual. This allows the individual to choose how they receive their services and from what providers and receive unbiased support to do so.

The comprehensive solution provided by MediSked enables:

  • Automated Goal and Task creation powered by the Care Management Comprehensive Assessment (CMCA), which allows Care Managers to easily track next steps and suggested supports for individuals
  • Robust reporting to track activities and give insights
  • Digital claims submission with billing exceptions to prevent billing errors
  • Medication Review to proactively identify risks for an individual and ensure they understand what they are taking and why
  • A customizable Individual More Information Page to gather basic information with specialized experiences to track Hospitalizations, Documents, Allergies and more.

MediSked looks forward to continuing our relationship in North Carolina to improve efficiencies, lower costs, and improve outcomes for individuals supported by these organizations.

Visit this page to learn more about MediSked’s solutions for North Carolina-based health and human services organizations.

Jackie Beiter

Jackie Beiter

Jackie Beiter, Product Manager at MediSked, joined the company in 2019. Prior to her role in Product, she’s also worked in Customer Support and Software Testing and uses these experiences to build impactful solutions to improve care and outcomes for individuals supported by the organizations using MediSked’s platforms.

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