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Attention Providers Affected by Hurricane Helene: If your organization is facing challenges due to Hurricane Helene and need assistance with medical, personal care, or specialized supplies, we are here to support you.  Please reach out to Carolina Complete Health as we are coordinating relief efforts for providers in the affected areas of Western North Carolina.  Click Here for More Information.

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

Provider Materials

Page Last Updated: 10/04/2024