NC*Notify Helps Fulfill Tailored Care Management Data Requirements
Tailored Care Management plans are a community-based, provider-driven model, contracted with Medicaid to provide whole person care, primarily focused on behavioral health and intellectual/developmental disability care. These plans are scheduled to be live on April 1, 2023; however, some providers went live on December 1, 2022.
TCM Providers must meet several technology requirements, including access to ADT (Admission, Discharge, Transfer) data that alerts providers when members are admitted, discharged, or transferred to or from an emergency department (ED) or a hospital in real time or near-real time.
NC*Notify, the ADT notification service for NC HealthConnex, can help participating health care organizations meet these requirements by providing real-time notifications anytime a patient has one of the following triggering events:
- Transitioning in or out of hospital as an inpatient
- Visiting an Emergency Department
- Transitioning out of a residential setting or between clinical and residential settings
Transitional care management is expected of TCM providers. In addition to accessing ADT alerts, managers must ensure there are systems and processes in place to support care transitions and respond to high-risk situations, such as ED visits.
Visit the N.C. Department of Health and Human Services website to learn more about Tailored Care Management and the technical requirements.
You can also visit the Suite of Services page to learn more about how NC HealthConnex services, such as NC*Notify can help your practice meet the goal of whole-person care.
What Does the Law Mandate Now?
The mandate to connect to the state-designated health information exchange, NC HealthConnex, required that those receiving state funds, such as Medicaid and State Health Plan, initiate their connection by January 1, 2023.
While the law regarding this connection mandate is complex, we hope the following will provide some clarification:
- Signing a participation agreement demonstrates a good-faith effort to meet the connection mandate.
- Once you have an executed agreement, meaning that both your practice and the NC HIEA have signed, you are placed in the onboarding queue where your organization will wait for an invitation to begin your technical connection.
- Actively engaging in the onboarding process with your technical vendor and the NC HIEA also demonstrates a good-faith effort to meet the connection mandate.
At this time, thousands of provider organizations are in various stages to complete their connection.
We encourage providers to begin training while they are in the onboarding queue. We offer training materials such as webinars, user guides, and self-paced modules on our website. You can also request training for your practice using this form.
We appreciate your patience as you wait to complete your connection. If you would like more information, please reach out our provider relations team at firstname.lastname@example.org or give us a call at 919-754-6912. You can also view our connection deadline FAQs.
A report of which health care organizations have or have not connected to NC HealthConnex will be submitted to the N.C. General Assembly this legislative session.
NC HealthConnex Helps Meet Requirements for Incentives through Quality Payment Program
Data provided by the NC HIE, NC HealthConnex, can help your organization meet requirements for payment incentives through the Quality Payment Program (also known as MIPS, Medicare Incentive Payment System). Meeting these requirements can help your practice receive extra incentives and higher payments.
Providers that can attest that they participate in a bidirectional data exchange with an HIE meet one objective for the measure of Promoting Interoperability. NC HealthConnex also provides several other services, such as Direct Secure Messaging and access to the North Carolina Immunization Registry, which help meet objectives for this measure. See more on the available measures and required objectives.
MIPS eligible clinicians have until 8:00 p.m. on March 31, 2023, to submit their data for the 2022 performance year. To learn how to submit your 2022 MIPS data, visit the Quality Payment Program website.
- Teletown Hall: Firsthand User Experiences – Wednesday, February 22, 2023, 12 p.m. to 1 p.m. To register, click here.
- How to Connect Webinar – Monday, February 27, 2023, 12 p.m. to 1 p.m. To register, click here.
- Advisory Board Meeting – Thursday, March 2, 2023, 2 p.m. to 5 p.m. To attend, click here.
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