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NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will launch July 1, 2024. Choice period ends on May 15, 2024. Please call to select your PCP. Find PCPs available in our health plan.

Effective February 1, 2024, citizens of Harnett County are being served by Alliance Health. Access more information for or for providers.

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Provider Practice Transformation

This page will help guide our network providers through a process of sustainable change.

What is Practice Transformation?

Practice transformation refers to a process of change. It is designed to help provider agencies develop the tools, skills, and knowledge necessary to shift to measurement-based care and to participate in alternative payment models.

Alliance Health’s success as a health plan is intrinsically tied to the ability of our provider network to deliver high-value and cost-efficient care to our members. To this end, Alliance has developed a practice transformation program to helps guide our network providers through a process of sustainable change. Alliance’s practice transformation program is designed to assist provider agencies develop the tools, skills, workflows, continuous quality improvement processes, and knowledge necessary to make the shift towards measurement-based and outcome-driven care, enabling successful participation in alternative payment models. Practice transformation is not about developing interventions for providers to implement. It is a supportive process that ensures that provider organizations have the skills, data, and tools to monitor their performance, identify gaps and issues, and implement corrective actions and innovative approaches to improve the delivery of care.

How Alliance Will Work With Practices

Alliance offers a tiered approach to transformation, including a strategic transformation program for large providers and providers seeking care management certification. For practices that are not part of a formal transformation process, Alliance will share scorecards on several key measures and provide access to a resource library available on this site. Support will also be made available upon request from provider organizations who seek help on specific measures or issues.

EHR Funding Opportunity

Alliance Health is providing $1 million to help small providers and historically underutilized providers offset the cost of implementing or updating their electronic health record (EHR) systems. Interested providers should submit the Alliance Health EHR Funding Application. Additional details are available on the application form.

Provider Practice Transformation Academy

Plan Overview

Comparison of NC Medicaid Standard Plan, Medicaid Direct and Tailored Plan

Medical/Pharmacy

Financials/Contracts

Care Management Agency/AMH+

Foster Care: Tips For Providing Tailored Care Management
Functions/Responsibilities of Transitional Care Management, Part I
Functions/Responsibilities of Transitional Care Management, Part II: In-Reach and Transition
Functions/Responsibilities of Transitional Care Management, Part III: Diversion from Institutional Settings
Making the Decision to Become a CMH/AMH+
Member Contact and Documentation Requirements for Tailored Care Management
Q&As for CMAs/AMH+s
Risk Stratification
Staff, Caseload, and Financial Modeling Tools for CMAs AMH+s
Step-By-Step Guide to Working with Members as a CMA/AMH+
Tips for Engaging Members in Tailored Care Management
Tips for NCQA Site Review Submission
TP CM Engagement Workflow with Acuity Timeline
Transitions for Members in State Facilities
Verification of Education and Experience for Tailored Care Management Staff
Warm Handoffs and Transitions for Services Excluded from Tailored Care Management
Warm Handoffs from Alliance to Provider-Led Tailored Care Management

Innovations

DSS Innovations Request Letter
Innovations Budget Basics
Innovations Submission Document Checklist
Innovations Waiver/Freedom of Choice Form
Limits on Sets of Services

Forms

Care Management Opt Out/Change Provider Form
Daily Team Huddle Template
IDM Form B
Transition of Care Warm Handoff Summary

This page was last reviewed for accuracy on 09/07/2023