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The state’s 10 local management entity-managed care organizations, including Smoky Mountain Center, plan to consolidate into four regional LME-MCOs.

Map courtesy N.C. DHHS

Originally published: 2014-01-18 16:20:27
Last modified: 2014-01-20 12:03:01

Smoky Mountain Center to consolidate

by Anna Oakes

Leaders of Smoky Mountain Center -- the organization that administers public funding for mental health, developmental disabilities and substance abuse services in 23 Western North Carolina counties -- last week discussed efforts to prepare for anticipated organizational and funding changes.

In December, the N.C. Department of Health and Human Services announced that the state's 10 local management entity-managed care organizations, including Smoky Mountain, would consolidate into four regional LME-MCOs.

"The consolidation to four LME-MCOs will help create a more sustainable behavioral health system while continuing to improve services through more efficient delivery of care," said Mary Hooper, executive director of the N.C. Council of Community Programs, in a statement. The council represents the state's LME-MCOs.

Smoky Mountain's service area recently grew from 15 counties to 23 in October, when it merged with the Western Highlands Network. The new proposal would combine Smoky Mountain with Winston-Salem-based CenterPoint Human Services and Gastonia-based Partners Behavioral Health Management, according to DHHS.

"We don't have the timeline for that yet," said Brian Ingraham, CEO of Smoky Mountain Center, on Thursday. "The General Assembly has the ultimate authority for approving anything the state will do. This spring and summer will be very revealing."

In anticipation of the consolidation plans, Smoky Mountain, CenterPoint and Partners Behavioral formed the Western Regional Partnership in November, with leaders holding several meetings since then to discuss standardization of practices.

"We're doing things that just make sense to do a better job ... so that things can be more consistent for consumers and providers," Ingraham said. He said the leaders have not yet begun to discuss the specific impacts of consolidation on staffing.

The LME-MCOs, which manage approximately $2 billion in Medicaid funding, last year completed a transition from a fee-for-service system to a managed care model, in which providers receive a set amount of money from the state to provide treatment.

"We have accomplished the financial goals set by the state in creating predictability in the Medicaid budget while operating within the rates set by Medicaid," Ingraham said in a statement. "At the same time, we have assured that medically necessary care has been delivered and managed in a way that provides the greatest possible benefit to consumers and families."

Ingraham said Smoky Mountain is continuing efforts to move to a comprehensive care model of treatment, which seeks to better integrate services in a community so that providers collaborate to improve health outcomes for patients. Ultimately, the system is working to achieve greater integration between mental and physical health services as well, he said.

"We have to look at opportunities for efficiency and of course be very sensitive about quality," he added.

State leaders are currently working to develop additional measures to reform the state's Medicaid system, with a DHHS reform proposal due to the General Assembly on March 17. The reforms could mean additional changes for the state's mental health, developmental disability and substance abuse service providers.

Smoky Mountain Center's access line for those in need of mental health, developmental disability or substance abuse services is (800) 849-6127.