CEO: Network seeking partnership

Apr. 24, 2013 @ 05:11 AM

The Western Highlands Network is leaning towards developing a partnership with another Local Management Entity (LME) in the state.

Charles Schoenheit, interim CEO of Western Highlands said Tuesday that was the next logical part of the process after the network learned it’s 1915 (b)/(c) Medicaid waiver contract with the state’s Division of Medical Assistance (DMA) will be terminated on July 30.

“The next step for us is to find another MCO of whom we can partner,” Schoenheit said. “We are in the process of evaluating those and I would expect a decision on that rather soon.”

Schoenheit said that there has been interest from other LME’s in the state on developing a partnership with the network. Among the LME’s, he said that Alliance (Durham), Center Point (Winston-Salem) and the Smoky Mountain Center (Sylva) have made contact with the Western Highlands Network to discuss a partnership potential.

All three of those are current MCO’s within the state’s system. Schoenheit said that a decision could be reached “in the next few days” on a direction to go in.

“It’s not really a buy-out, it is more of a partnership,” Schoenheit said. “There is really nothing to buy-out.”

While the effects of a partnership aren’t known, Schoenheit said that staffing at Western Highlands will not see a drastic change.

“Our hope is that whoever we partner with will need our staff,” Schoenheit said. “They may not need all of them but I would expect that a majority of our staff will be needed to maintain those services.”

Initially, Carl Classen, Rutherford County manager and treasurer of the Western Highlands Board of Directors, said the group may explore being a pilot program for Gov. Pat McCrory’s initiative which would overhaul the state’s Medicaid program by having managed care companies offer health care plans to poor children, the elderly and the disabled.

Schoenheit said that has no longer become a feasible option for Western Highlands.

“That option was taken off the table by DMA basically because it would take took long to implement and it would be very difficult,” Schoenheit said. “We may look at it for the future but it is really not doable for the immediate future.”

Regardless of what the future holds for Western Highlands, Schoenheit said client services will maintain through a potential transition.

“We’ve got several months ahead of us to plan the changes we are going to make,” Schoenheit said. “Our clients receive benefits from our network and it would be our hope that those services would continue as they are.”

Even now Schoenheit said new clients are being brought into the system.

“If we do this right, consumers should not see any change in the services they are receiving,” Schoenheit said.

Two weeks ago DMA notified the network of its decision to terminate its contract for the waivers. State officials said that the contract was terminated “without cause.” Members of the Western Highlands board suggested that the deadline be moved back to Sept. 30 and even Dec. 31.

“We were dismayed that they would make that kind of a decision,” Schoenheit said. “I don’t think we are going to get any additional explanation. It was within the contract for them to do it and that is what they chose to do.”