Eastpointe, Altruista partner to ease NC’s Medicaid overhaul

Health plan Eastpointe and Altruista Health are teaming up to help ease a massive transition in the North Carolina Medicaid program.

Health plan Eastpointe and Altruista Health are teaming up to help ease a massive transition in the North Carolina Medicaid program.

Altruista, a Washington-based health IT company, will support Eastpointe during North Carolina’s move to a fully integrated Medicaid managed care program, which state officials contend is the largest change to North Carolina’s Medicaid program in more than 40 years.

The partnership follows the passage of a North Carolina law in June 2018, authorizing the carve-in of behavioral health services into standard benefit plans and the creation of specialized managed care products targeted toward individuals with significant behavioral health needs. Passage of the bill will effectively put the majority of the North Carolina’s Medicaid population into integrated managed care products over the next several years.

For the venture, Eastpointe— a managed care organization in eastern North Carolina—brings to the table coordination of public behavioral healthcare for Medicaid beneficiaries with mental health challenges, including substance use issues, and intellectual and developmental disabilities.

Eastpointe currently works in partnership with 247 agencies, 47 licensed independent practitioners and 41 hospitals in 10 counties in North Carolina to help families get the comprehensive services they need.

Through a suite of web applications, Altruista’s GuidingCare technology platform will provide the integrated care management, care coordination and quality improvement programs for North Carolina’s Medicaid overhaul. “GuidingCare helps health plans and providers transform their processes, reduce avoidable expenses and improve patient health outcomes,” Altruista says.

Sarah Stroud, Eastpointe’s CEO, says the plan chose to partner with Altruista because the IT firm has “strong experience” in clinical health plan operations, behavioral health and the social determinants of health (SDOH). “This experience makes it the best choice for us to improve our member services,” she says. “We’ve been focused on behavioral health and delivering whole person care. Adding physical healthcare and pharmacy requires us to have a comprehensive foundation in technology to continue to serve our members with excellence.”

Mike McKitterick, Altruista’s executive vice president of clinical services, says Eastpointe “has all of the fundamentals to translate its expertise in behavioral health to a broader health plan paradigm because the biopsychosocial approach also works well in chronic care management. We are well-positioned to support them from a technology and people standpoint because we have tools and expertise in both realms,” he says. “Our blended perspectives can enable a smoother transformation for Eastpointe.”

Altruista’s GuidingCare was the first care management platform to directly integrate SDOH into the member care plan, providing real-time access to social services search-and-referral tools, according to Altruista. The new partnership will have Eastpointe using Altruista’s Mobile Clinician app, which extends GuidingCare functionality into remote and rural areas that may have unreliable internet connectivity, the company says.

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