Message from the CEO - November 2018

Cardinal Innovations Healthcare — November 08, 2018
This month I’m going to focus on three things: First, waiver renewals - we need you involved. Second, an update on Medicaid Transformation and what that progress means for you. And finally, some recent good news about Cardinal that I believe signals our commitment to our members. Let’s jump right in.
Waiver Renewal Feedback
If you’ve been reading these monthly updates, you already know I’m committed to sharing information with you about upcoming changes I believe we can expect to North Carolina’s Medicaid program – whether that’s updates to NC’s existing Medicaid waivers, Medicaid Transformation, or anything else that might affect our members. This month, I’m going to talk about all three of these.
The most time-sensitive issue is the upcoming changes to NC’s Medicaid waivers, which support the vast majority of our members. The NC Innovations Waiver and the NC MH/DD/SAS Waiver, also collectively known as the 1915(b)(c) Waivers, provide Medicaid coverage to support people with mental health conditions, intellectual or developmental disabilities, and substance use disorders.  

The NC Department of Health and Human Services (DHHS) is in the process of renewing these waivers with the federal government, and through this process, NC DHHS has the opportunity to make some changes to the way the waivers operate. Late last month, NC DHHS posted copies of the new draft waivers for the public to review – you can find and review copies of the draft waivers here.
Most importantly, through this renewal process, there is a 30-day window for the public to provide feedback on the proposed changes to the waivers. This window comes to a close on November 22 for the 1915(c) waiver and November 28 for the 1915(b) waiver.  
I’d encourage everyone to get involved in this feedback process. It’s only through active participation from members, families, providers and other stakeholders that we can make the system work better – please review the proposed waiver changes and provide feedback if you have it. We’ve also created a video to help summarize and explain the proposed changes that you can watch here.
  • NC Innovations Waiver, or the 1915(c) Waiver: comments may be submitted by email or voicemail through November 22 to or 919-855-4968. 

Medicaid Transformation
Last month the federal government gave their official approval to North Carolina’s draft Medicaid reform plan that will move all Medicaid services to a managed care model – this plan is also known as an 1115 Waiver. The federal government has been reviewing the State’s Medicaid reform plan since it was submitted over two years ago, so this is a big development and step forward for Medicaid Transformation in NC. It’s important to note that while this is a major milestone, it does not directly impact the timing of Medicaid Transformation or its implementation. Rather, it’s more of a formal approval that gives the state permission to move forward with the plan as it’s already set forth. You can read more on the entire Medicaid Transformation process and stay up-to-date with the latest developments here.
Commitment to Quality
Ensuring our members have access to high-quality care and constantly finding ways to improve our values and standards that have been important to Cardinal Innovations for a long time. In 2009, we first sought and achieved accreditation as a Medicaid Managed Behavioral Health Organizations (MHBO) through the National Committee on Quality Assurance (NCQA).  This accreditation evaluates how well a health plan manages all parts of its delivery system—physicians, hospitals, other providers and administrative services—in order to continuously improve health care for its members.  I’m proud to say that Cardinal Innovations has maintained this MBHO accreditation since 2010.
Today, I am excited to share with you that we just completed our latest NCQA accreditation review and achieved our highest score ever - 98 out of 100.  We also sought an NCQA distinction for our Long Term Services and Supports (LTSS) for the first time, and achieved a perfect score of 100.  Cardinal is the first LME/MCO in the state to achieve NCQA accreditation, and I am proud of our talented, hard-working teams for meeting the high standards put in place by this program.  As a member, I hope that our long-time commitment to achieving this accreditation shows you how focused we are on our member’s care.
As Medicaid Transformation continues to move forward in North Carolina, NC DHHS is making sure that quality of care that will be delivered to Medicaid enrollees is documented and measured in a standardized way across the state. To achieve this, they have indicated that each Managed Care Organization working in the state must be accredited by the largest national accrediting organization in the country: the National Committee for Quality Assurance (NCQA).
There is a quote on NCQA’s website that speaks to me as a member of the Cardinal team, and captures our focus on high-quality care for our members: “improve by doing certain things the right way, at the right time, every time.”
That’s how the team at Cardinal thinks about our mission and our members every day.
Trey Sutten, CEO
Cardinal Innovations Healthcare

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