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North Carolina's Medicaid managed care services (MCO) propose consolidation plan

Ten organizations responsible for the management of mental health, substance abuse and intellectual developmental disability services across North Carolina are set to consolidate into four regional local management entities-managed care organizations (LME-MCOs) this year.  

LmE MCOs2

The plan from the N.C. Council of Community Programs, which represents the LME-MCOs, specifies that the proposed system will have three main characteristics:

  • Four regions (1 Western, 2 Central, 1 Eastern)
  • Geographic contiguity (with the exception of existing MCO configurations)
  • 300,000-350,000 covered lives per region

“This consolidation will help the system by allowing more standard forms and process across the board, as well as a consistency of Information Technology (IT) platforms among the MCOs. Monarch staff has been working with those at the MCOs through various committees to ensure that services and support are consistent. Without consolidation, this would not have been as doable,” Monarch CEO Peggy Terhune said.

The attached map indicates the four regions proposed by the N.C. Council of Community Programs. Pending final approval of the plan, The N.C. Department of Health and Human Services will work with the Council and LME-MCO leadership on a timeline for consolidation.

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