Vaya, Cardinal merge to tackle Medicaid transformation

Two of North Carolina’s largest managed care organizations recently announced that they would be joining forces in preparation for the state’s transformation into Medicaid Managed Care.

Vaya Health and Cardinal Innovations have already started transition efforts, with Vaya taking on responsibility for coordinating services and support for Cardinal Innovations members after the consolidation. Together, the organizations will work towards a seamless transition that focuses on integrated, compassionate care for people with mental illness, substance use disorders, and / or intellectual and developmental disabilities.

Vaya Health currently provides services to individuals in 22 counties in western North Carolina. If approved by the NC Department of Health and Human Services and District Representatives, the consolidation will expand Vaya’s operations to include benefits for the individuals and districts served by Cardinal Innovations. The proposed consolidation marks the fourth such endeavor for Vaya after successfully leading previous mergers with New River Behavioral Healthcare in 2007, with the Foothills Area MH / DD / SA Authority in 2008 and with Western Highlands Network in 2013.

Vaya’s experience of transitioning members through consolidation efforts will be particularly beneficial as the state’s public health system undergoes significant transformation. The first phase of NC Medicaid Transformation begins July 1, 2021 with five commercial health plans ready to manage integrated health benefits for the majority of Medicaid members.

As part of the second phase of the transition to BH and I / DD Tailored Plans, expected to take effect in July 2022, Vaya and Cardinal Innovations expanded their operations to provide fully integrated care for people with severe mental illness. a severe emotional disorder, severe substance use disorder, intellectual disability / developmental disorder, or traumatic brain injury.

Consolidation of the two organizations will enable a stronger health plan to serve those cared for through the North Carolina public health system, according to a press release. It will also bring the necessary stability to the members in the counties supported by Cardinal Innovations.

“We believe we can all benefit when we work together to meet the needs of our communities,” said Brian Ingraham, President and CEO of Vaya Health. “Our number one priority during this transition will be to support members, providers and counties and avoid any interruption in supply. We remain committed to offering a successful public service option as a bespoke plan. It is a privilege to have the opportunity to strengthen the public model, support our county partners, and help even more North Carolinians on their way to health and wellbeing. “

“The passion and commitment of Vaya staff to serve our members and communities is unmatched,” said Rick French, chairman of the Vaya Health Board. “The board is excited to expand this work to ensure that Cardinal Innovations health plan members continue to receive quality service and support.”

“We believe in our mission to improve the health and well-being of our members and their families,” said Trey Sutten, CEO of Cardinal Innovations. “It has become increasingly clear that to accomplish this mission we must consolidate with a strong organization that has a history of serving the needs of members and the community and the disruptions caused by the Medicaid transformation and county realignment can stabilize. I’ve known Brian and the Vaya team for years and know that our members, providers and communities are in the best of hands. “

The leadership of the two organizations will work closely with DHHS and representatives from local and state governments to ensure a successful transition. The boards of each organization will establish a joint steering committee to lead the development of a transition plan that puts the needs of members, vendors and counties at the forefront of the planning effort.

The Vaya leadership will visit each county to hear their concerns and learn about the specific needs of each ward. The consolidation of the two companies, led by Vaya Health, is expected to be completed by June 30, 2022.

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