As part of our transition to the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan, Alliance Health and other LME/MCOs launched Tailored Care Management (TCM) for members on December 1.
TCM is a community-based, provider-driven model that aims for whole person care and better health outcomes for the people we serve.
TCM provides Tailored Plan beneficiaries with a single designated care manager supported by a multidisciplinary care team to provide whole-person care management that addresses all of their needs including physical health, behavioral health, I/DD, traumatic brain injuries (TBI), pharmacy, long-term services and supports (LTSS) and unmet health-related resource needs.
Tailored Care Management will be available throughout the entire duration of a beneficiary’s Tailored Plan enrollment and is based in provider settings as much as possible, supporting integrated care and collaboration. TCM prioritizes frequent in-person interactions between community-based care managers and beneficiaries.
The TCM model emphasizes outcomes and population health management and depends on Tailored Plans, Advanced Medical Home Plus (AMH+) practices, Care Management Agencies (CMAs), pharmacies, and physical health, behavioral health and I/DD providers using a coordinated approach to beneficiary care.
The NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan will launch statewide on April 1, 2023.