Two of North Carolina’s largest managed care organizations announced that they will consolidate in preparation for the state’s transformation to Medicaid managed care. Vaya Health and Cardinal Innovations have already begun transition efforts, with Vaya assuming responsibility for coordinating services and supports for Cardinal Innovations members once consolidated. Together, the organizations will work toward a seamless transition focused on integrated, compassionate care for individuals with mental illness, addiction and/or intellectual and developmental disabilities (I/DDs).
Vaya Health currently manages services for individuals in 22 counties in western North Carolina. If approved by the North Carolina Department of Health and Human Services (DHHS) and county representatives, the consolidation will expand Vaya’s operations to encompass benefits for the individuals and counties served by Cardinal Innovations. The proposed consolidation marks the fourth such endeavor for Vaya, having successfully led previous mergers with New River Behavioral Healthcare in 2007, Foothills Area mental health/developmental disability/addiction (MH/DD/SA) Authority in 2008 and Western Highlands Network in 2013.
Vaya’s experience with transitioning members through consolidation efforts will be especially beneficial as the state’s public health care system is undergoing a significant shift. The first phase of North Carolina Medicaid Transformation will launch on July 1, 2021, with five commercial health plans poised to manage integrated health benefits for the majority of Medicaid enrollees. As part of the second phase of transformation to behavioral health and I/DD Tailored Plans, which are expected to launch in July 2022, Vaya and Cardinal Innovations have been preparing to evolve their operations to offer fully integrated care for people with a serious mental illness, a serious emotional disturbance, a severe addiction, an I/DD, or a traumatic brain injury.
The consolidation of the two organizations will enable a stronger health plan to serve individuals who receive care through North Carolina’s public health care system. It will also bring needed stability to members in counties served by Cardinal Innovations. The organizations are committed to bringing the best of both together to ensure the widest range of services, highest quality care, and unparalleled commitment to local communities.
Leadership for the two organizations will be working closely with DHHS as well as local and state government representatives to ensure a successful transition. The Boards for each organization will establish a joint steering committee to guide the development of a transition plan that puts member, provider organization, and county needs at the forefront of planning efforts. Vaya leadership will be visiting with each county to hear their concerns and learn about the unique needs of each community. Consolidation of the two entities under Vaya Health leadership is expected to be completed by June 30, 2022.
Vaya Health is a public managed care organization that oversees Medicaid, federal, state, and local funding for prevention, treatment and crisis services delivered by practitioners and provider organizations in Vaya’s contracted network. Vaya manages services and coordinates care for individuals in 22 western North Carolina counties, home to more than 1 million residents. Vaya’s local model ensures that each county receives individualized attention and support to meet the unique needs of each community. Every day, Vaya works with provider organizations, local stakeholders, and members to develop needed services, supports and educational programming for a healthier North Carolina. The organization has a proven track record of meeting or exceeding the state’s clinical benchmarks and maximizing public funds to reach more citizens per capita than any other local management entity (LME)/managed care organization (MCO). Access to care and crisis assistance are available 24/7 at 1-800-849-6127.
About Cardinal Innovations Healthcare: Cardinal Innovations Healthcare is a specialized health plan and care coordinator for Medicaid recipients and the under- and uninsured in North Carolina with complex behavioral and special needs. Cardinal Innovations connects people with treatment and support for mental health, I/DDs, and addiction through a network of provider organizations in their communities. In 2020, Cardinal Innovations administered nearly $850 million for the care of 825,000 people in the region and invested more than $50 million to improve support systems and to respond to coronavirus disease 2019 (COVID-19). Cardinal Innovations also works with local governments to address public health concerns such as homelessness, suicide prevention, child welfare and domestic violence through education, engagement, and outreach.
This was reported by Cardinal Innovations Healthcare on June 01, 2021.
Contact information: Vaya Health, 200 Ridgefield Ct., Asheville, NC 28806; 828-225-2785; Website: https://www.vayahealth.com/
Contact information: Ashley Conger, Chief Communications Officer, Cardinal Innovations Healthcare, 10150 Mallard Creek Rd., Suite 400, Charlotte, NC 28262; 704-467-3808; Fax: 704-939-7907; Email: email@example.com; Website: https://www.cardinalinnovations.org/Contact