Today we bring you important news from NC Division of Health Benefits:

The Advanced Medical Home (AMH) is NC Medicaid’s cornerstone primary care program, serving more than 2 million Medicaid members across the state. Innovative primary care payment is critical to supporting practice improvements that lead to the outcomes that matter to Medicaid enrollees and their families. 

Prepaid health plans (PHPs) are currently required to offer performance incentive payment arrangements to AMH practices based on a defined set of AMH quality measures; however, provider feedback and formal PHP reporting indicate that approach to these arrangements varies widely among PHPs. This variability makes it difficult for AMH practices to consistently participate in incentive arrangements across plans and to focus and align their quality improvement efforts for Medicaid members.   

To address these challenges, NC Medicaid plans to implement the AMH Standardized Performance Incentive program in 2026. Additional details can be found in the draft AMH Standardized Performance Incentive Program Policy Guide, which is being shared for community partner input. 

Standard Plans and Tailored Plans would be required to offer this program to all AMHs. Participation in the program is optional for AMH practices, and PHPs and AMHs may agree to other Value-Based Payment models in addition to or in lieu of this program, if desired. 

The AMH Standardized Performance Incentive program was developed as a feature of North Carolina’s participation in the Centers for Medicare & Medicaid Services (CMS) Making Care Primary (MCP) model. CMS recently announced the MCP model will be ending early by Dec. 31, 2025, nine years earlier than planned. While the Medicare MCP model will not be continuing, the Department’s proposed AMH Standardized Performance Incentive program remains an important step to advance NC Medicaid’s goals of reducing provider burden and improving health outcomes.

NC Medicaid is seeking additional feedback from community partners on the design of the AMH Standardized Performance Incentive Program and will continue to meet and collaborate with community partners and CMS in the consideration and design of this proposal. 

Community partners are encouraged to provide feedback on the draft AMH Standardized Performance Incentive Program Policy Guide by emailing Medicaid.NCEngagement@dhhs.nc.gov (subject line “AMH Standardized Performance Incentive Program Feedback”) by April 21, 2025.

Collaborative Care Management (CoCM) Capacity Building Fund

APPLICATIONS OPEN APRIL 1 FOR PHASE 2

Applications remain open for Phase 1

The first-of-its-kind Children and Families Specialty Plan will go live on December 1, 2025. This is a single, statewide NC Medicaid Managed Care plan that will wrap Medicaid-enrolled children, youth and their families in the child welfare system with seamless, integrated and coordinated health care. 

NCDHHS and Blue Cross NC’s highest priority is to deliver a plan that meets the needs of the children and families of North Carolina. We are committed to building the systems and processes needed to ensure the Plan works for families and the counties that serve them. Since the contract was awarded in August 2024, we have been working together to and carefully planning to ensure the launch of the new plan goes smoothly and is ready to serve beneficiaries on day one.  

Over the next year, we will be working quickly and collaboratively to ensure that we are ready to support children and families by providing coordinated and comprehensive health care, including mental health care, that follows the person and works across multiple systems. 

We will also support providers in preparing to best serve this population under the new plan including extensive training and working with providers to address unmet health-related resource needs, including housing, food, transportation, and interpersonal violence. And, of course, we will collaborate with county leaders, DSS staff, community partners and stakeholders while preparing to support children and families in this new way of accessing care.  

What is the Children and Families Specialty Plan? 

• The Children and Families Specialty Plan is a new single, statewide Medicaid Managed Care plan that will wrap Medicaid-enrolled children, youth, and their families currently and formerly served by the child welfare system with seamless, integrated and coordinated health care. 
• The Plan will operate statewide, ensuring members can access the health care services they need, including mental health care, and continue to work with their doctors as placements may move them across the state.  
• The Plan is part of North Carolina’s commitment to improving the long-term health and well-being of children experiencing the child welfare system and to strengthen and support families. 
• To implement the Plan, NCDHHS will work with Blue Cross and Blue Shield of North Carolina (Blue Cross NC), who will manage it under the name Healthy Blue Care Together.  

• One, single statewide plan: The Plan will operate statewide as the single entity accountable for the health care of its members, simplifying processes and providing caregivers, providers, case workers and families with the information to provide the right care at the right time.  
• Informed by local needs: The Plan will collaborate with County DSS, local stakeholders and families to understand and respond to needs in each community. Care managers will be located within the community to support this work. 
• Prevention focused: The Plan will take a family-focused approach to care delivery to strengthen and preserve families, reduce entry and re-entry into foster care, and support reunification and other permanency plan options. 
• Comprehensive care: The Plan will increase timely access to a broad range of physical health, behavioral health, pharmacy, long-term services and supports (LTSS) and I/DD services, as well as unmet health-related resource needs for all members. 
• Coordinated care: The Plan will provide care management to all members to support integrated, whole-person care and facilitate coordination among service providers. It will also facilitate seamless transitions for members who experience changes in treatment settings, child welfare placements, transitions to adulthood and/or loss of Medicaid eligibility.  

• We will continue to share regular updates and also hold meetings with key stakeholders and organizations. 

Stay Connected and Get Involved with the work happening at DMH/DD/SUS!

Visit the DMH/DD/SUS Website 

It's National Kidney Month!

Chronic kidney disease affects nearly 37 MILLION people in the country (more than 1 in 7 adults). 

Chronic kidney disease often causes no symptoms until it is more advanced.

Chronic kidney disease is progressive.

Chronic kidney disease puts people at risk for other serious health problems like heart attack, stroke and kidney failure.

One in three adults with diabetes (and one in five with hypertension) may have chronic kidney disease (CKD).

90% of people with it DO NOT KNOW THEY HAVE kidney disease!

Back to our title, "it takes two to make a thing go right": Two tests should be done to look for CKD. Fewer than half of patients at high risk for CKD are screened appropriately.

How to screen?

• Spot urine ACR (albumin-to-creatinine ratio)

AND

• eGFR (estimated Glomerular Filtration Rate)

Get started now to help make this thing go right!

It is crucial for healthcare providers to be well-equipped with the knowledge and skills necessary to effectively discuss immunization with patients and caretakers who might harbor doubts or feel hesitant about vaccines. This involves understanding the underlying reasons for their hesitancy, which can range from misinformation and fear of side effects to cultural beliefs and past experiences. By being empathetic and informed, healthcare providers can build trust and provide clear, evidence-based information that addresses specific concerns, ultimately helping to alleviate fears and encourage informed decision-making regarding vaccinations.

A report from the American Academy of Pediatrics explains the possible causes behind vaccine hesitancy and suggests ways to address different types of concerns.

The AAP also provides a variety of communication aids and guides to encourage conversations about vaccines.

To learn more, check out the ADL's March 15 Highlighted Resources:

Strategies for Improving Vaccine Communication and Uptake

AAP Immunization Communication Aids

Current guidelines: begin colon cancer screening at age 45.

The United States Preventive Services Task Force (USPSTF) recommends that all people at average risk begin colon and rectal cancer screening at age 45. People at higher risk may need to be screened earlier.  

Why was the screening age lowered?

• In the U.S., about 10% of colorectal cancer cases are diagnosed in individuals under age 50.
• Young-onset rectal cancer incidence has increased at nearly two times the rate of young-onset colon cancer.
• It is predicted that by 2030, colorectal cancer will be the leading cause of cancer deaths in people ages 20-49.

Colorectal cancer screening often focuses on detecting polyps. Pre-cancerous polyps usually take about 10-15 years to develop into cancer. It is vital to find them EARLY before they have a chance to grow, spread and turn deadly, and THEN cause symptoms! 

One woman's story:

"The only risk factor I had was being 55 years old. No family history of colorectal cancer, I had no symptoms, I am physically active and eat a healthy diet. I really did not want a colonoscopy, so I had Cologuard screening instead. It came back positive! My colonoscopy showed three very large, but thankfully pre-cancerous polyps. These were removed and honestly, I believe my life was saved. GET SCREENED!"

Our colleagues at Wake AHEC in Raleigh, NC are offering a one-day, in-person workshop to provide updates on HIPAA Compliance issues for local health departments. 

Date and Time:

June 26, 9:00 AM - 4:00 PM

Core topics of the workshop include:

• Hybrid entity designations
• Breach response
• Business associate relationships
• Sharing information with local Departments of Social Services

Faculty:

Jill D. Moore, JD, MPH, Associate Professor of Public Law and Government

Kirsten Leloudis, JD, MPH, Assistant Professor of Public Law and Government

Learn more and register

The most recent 'NC Medicaid/NC AHEC Office Hours' highlighted several important tidbits regarding NCTracks. If you were not able to attend, don't worry!

• The User Login process is changing in 2025, and will require multi-factor authentication. This will occur in phases and email notifications will be sent.
  
  You do not have to wait for your e-mail notification---you can go ahead and update your user login now.
  
  Learn more about Multi-Factor Authentication (MFA) for NC Tracks users.
  

• Change of Ownership notification required at least 30 days prior to the change taking place.
  Learn more about Change of Ownership guidelines and FAQ's 
  
  
  
  
• Why does it matter if Provider Records in NCTracks are not up to date?

Additional topics were covered during this call. You can review a pdf of the slides from today's office hours here.

Northwest AHEC invites you to our upcoming Spring Behavioral Health Webinars! Whether you're looking to enhance your clinical practice, support recovery, or deepen your understanding of trauma-informed care, we have valuable sessions for you. Click below for more information on each.

• Appetite Awareness Training for Binge and Overeating - March 25, 2025 from 9AM-11AM - This program will examine the factors (e.g., trauma, stress, depression) that may increase binge and overeating in our clients, with particular emphasis on clients who are low income, and identify as a member from a racial/ethnic minority group. Register Here
  
  
• Microaggression as an Ethical Issue in Clinical Practice - April 1, 2025 from 9AM- 12:15PM - Microaggressions are subtle, often unintentional exchanges that convey negative messages based on race, gender, sexual orientation, age, or disability. While clinicians aim to provide culturally sensitive care, unknowingly committing microaggressions can harm communication, erode trust, and disrupt the therapeutic process. Ethical guidelines call for minimizing these occurrences to support effective client relationships. This program explores the impact of microaggressions, their role in clinical practice, and strategies for reducing them. Note: This course may count toward ethics requirements for license renewal. Register Here
  
  
• Practical Suggestions for Facilitating SUD Recovery - April 9, 2025 from 1PM - 3PM - Health professionals often encounter clients or patients with substance use disorders (SUDs). Understanding how to effectively address these complex challenges is critical for providing optimal care. This workshop is designed to offer a comprehensive overview of practical approaches and evidence-based interventions for working with individuals affected by SUDs. Register Here
  
  
• Safety First: Trauma-Informed Care with People Experiencing Substance Use Disorders - May 16, 2025 from 9AM - 12:15PM - Widely demonstrated in the literature on substance use disorders, trauma experienced by the person is a common and primary part of the sequelae leading to addiction. Traumatic life experiences can unfortunately also be a part of a person’s time as a substance user.
  This training will present a brief overview of what constitutes single incident or developmental traumas; what it means to be a trauma-informed practitioner; awareness of vicarious or secondary traumatization and related social worker self-care. Participants will learn how to consider trauma in their approach to working with clients and in their ability to thrive as a practitioner.  Register Here
  
  
• Race-Based Traumatic Stress: Broadening Your Toolkit to Support Diverse Individuals - June 20, 2025 from 9AM - 12:15PM - This session explores race-based traumatic stress and its impact on clients of color. We’ll review the theoretical framework, trauma responses, and resilience strategies while identifying risk and protective factors. Clinicians will enhance cultural competence through interactive learning, self-reflection, and practical skills for sensitive, effective care. Register Here

The role of Physician Assistant (PA) in North Carolina is integral to the healthcare system.  Physician Assistants are trained to provide high-quality care, often serving as primary care providers. 

Our colleagues from South Piedmont AHEC are offering a free lunchtime webinar to learn more about this important health care professional.

Overview of Physician Assistants in North Carolina -- Regulations, Scope of Practice, and Common Questions

April 30, 2025 | 12 PM - 1 PM

There is no registration fee for this webinar!