Eastpointe, a local management entity (LME) officially transitioned to a live Managed Care Organization on Jan. 1st 2013 and became responsible for the authorization of services for mental health, substance use, and intellectual and developmental disabilities.

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Online PR News – 18-March-2013 –The state of North Carolina has been leading the way in healthcare delivery redesign with the transition of care provided for Medicaid enrollees being designated by newly formed Managed Care Organizations (formerly Local Management Entities). The goal of these organizations, as stated on the NC Department of Health and Human Services website “is to create community health networks to achieve long-term quality, cost, access, and utilization objectives.” This is achieved through the provision of services by a network of providers who are contracted with the Managed Care Organization.

BHM consultants began working with Eastpointe on the transition to managed care back in 2010 when they assisted the organization in submitting an application to be chosen as one of the Managed Care Organizations. This work continued after selection, when BHM consultants worked with individuals at Eastpointe in a consultative and supportive role to ensure that the organization was able to be operational as an MCO by Jan. 1st 2013. This work included assistance with IT architecture, provider relations, quality management, clinical operations, URAC Accreditation, and financial advisory and analysis.

Eastpointe was one of five organizations who were selected to “go-live” Jan. 1st and successfully met the standards to become an MCO. “We believe that this is a fantastic success for our clients” stated Mark Rosenberg, CEO of BHM Healthcare Solutions. “Eastpointe is led by a phenomenal team of people, and it has been our pleasure working with them. We are excited to see their success in achieving this important milestone.”

BHM is a Healthcare Management Consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services ranging including accreditation, Healthcare Financial Analysis, clinical operations, Physician Advisor Services, quality improvement, and denial management.