METS

What is the METS (Members Empowered to Succeed) Program?

Our METS (Members Empowered to Succeed) Program is part of our comprehensive approach to member care to ensure resilient health outcomes. To assist with the member’s treatment progress, we partner with you, our providers, and members who have a higher intensity use of behavioral health outpatient services to encourage collaboration and coordination of additional resources.

METS is available for select Carolina Complete Health Medicaid members.

Benefits & Outcomes of METS

Integrated, whole health approach to member’s needs and care including behavioral health, medical, therapeutic, pharmacy, and supplemental
Dedicated team of specially trained Behavioral Health Clinical Liaisons and Service Coordinators, alleviating additional lift for providers
Identification of outpatient high utilizer trends to pinpoint members who could benefit from the program
Cross-care team partnership to ensure coordination of care and collaborative problem solving
Coordination of services and treatment between multiple providers
Reduction in administrative tasks with increased resources for care coordination
Knowledge of covered services such as expanded benefits or new programs and how to access
Arrangement of reminders and assistance with accountability for delivery of treatment/discharge plans
Access to various physicians and specialists to promote diversity among providers and treatment team

The METS Team

METS Clinical Liaisons:

Have knowledge related to the member’s health plan processes and programs that can assist you as the provider in the utilization management process
Are licensed clinicians who have both clinical and UM experience within managed care
Review the member’s treatment records and collaborate with the provider for additional clinical information and support
Develop a care strategy that best matches the member’s needs to the lowest acuity setting taking into account the member’s goals and desired outcomes with an emphasis on delivering high-quality care

METS Service Coordinators:

Have knowledge related to the member’s health plan processes and programs that can assist you as the provider in accessing covered and available service
Are skilled in motivational interviewing and identifying resource needs and will provide additional supports to your members
Partner with the Clinical Liaison and member to make sure that the treatment aligns with the member’s personal goals, taking into account social determinants of health, health literacy, and availability of community resources