Tailored Plans will start October 1, 2023
NC Medicaid changed the start date for Tailored Plans to October 1, 2023. Until October 1, 2023, you will keep getting services the way you do now. 

Information and processes on this page will be changing in the weeks to come. 
Learn about Tailored Plan here


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Strategic Planning & Outcomes

Where We are . . .
Business group discussing over graph during a meeting               Where We Want to Go

Trillium Health Resources participates in a number of review and analysis activities to help us examine our business practices and management operations.  Although each form of evaluation measures different things, the main purpose of these various checks and balances is to ensure we are being as effective and efficient as possible while meeting all regulatory requirements expected of us. 


Cultural Competency Plan

Trillium is committed to the well-being of our communities and we focus on helping every person we serve obtain the culturally appropriate services needed to improve well-being and live a fulfilling life.

Trillium’s cultural competency plan guides the processes, programs, and services to meet the needs of our culturally diverse population. Our evolving plan will set forth the vision for cultural competency improvements across our provider network and within Trillium.


Diversity, Equity, and Inclusion (DEI) Annual Report

Trillium’s Diversity, Equity, and Inclusion (DEI) Department works to foster an inclusive culture embracing the diverse backgrounds, experiences, and viewpoints of our communities. The report details the programs, initiatives, and strategic focuses working to fulfill that vision for Trillium’s staff, members, and communities.


Annual Report

Trillium’s annual reports detail not just the financials and statistics for each of our fiscal years, but also the personal impacts and successes experienced by our members and providers in our communities.


Financial Statement and Compliance Report

Each year, Trillium works with an independent auditor to examine our financial statements and provide an honest opinion of Trillium’s fiscal practices. The accountants view statements and materials according to the state fiscal year (July 1-June 30).


Value-Based Care

Trillium and its provider network are moving beyond the traditional fee-for-service model to create innovative value-based arrangements. Value-based care emphasizes outcomes so that payments are based on achieving realistic health goals, rather than payments based on number of visits. Visit our page for more information.


Local Business Plan

The Local Business Plan (LBP) is an LME/MCO strategic planning document looking at a three-year period for accomplishing stated goals to improve access, effectiveness, and quality of services.  It includes the opportunity to address our local approach to statewide initiatives as well as to outline initiatives that address regional needs identified in our Network Adequacy and Accessibility Report.


Quality Management and Improvement Plan (QMIP) & Work Plan Evaluation

The annual Trillium Health Resources QMIP outlines efforts to maintain and improve services for members. It frames the purpose of the Quality Management Program and activities to meet state and federal regulations as well as national accreditation standards.  

The annual QMIP outlines the objectives for the year by monitoring identified quality improvement issues throughout the organization. We review and revise the QMIP based on an annual evaluation of our Quality Assurance and Performance Improvement (QAPI)  Work Plan. 

Trillium establishes agency-wide goals that are measured and reported routinely to the Trillium Health Resources Quality Improvement Committee. The goals in the plan may address a variety of key performance areas, including but not limited to: follow-up after hospitalization, accessibility, availability, member satisfaction, education and outreach to members and their families. 

Trillium also seeks input for the Work Plan from various external committees, such as the Global Quality Improvement Committee, Provider Council, and the Clinical Advisory Committee


Member Satisfaction Survey

The Satisfaction Surveys for North Carolina Child and Adult Medicaid members provide a comprehensive tool for assessing health care experiences. DataStat, Inc. conducts the survey on behalf of The State of North Carolina Division of Health Benefits (DHB) and The Carolinas Center for Medical Excellence (CCME). The Experience of Care and Health Outcomes (ECHO®) Survey 3.0 assesses the performance of the health plans. The adult survey includes 63 questions while the child survey has a total of 70 questions that focus on the health care experience such as getting treatment quickly, how well clinicians communicate, getting treatment and information from the plan, perceived improvement, and overall satisfaction with counseling and treatment.


National Core Indicators® Survey

National Core Indicators® is a survey using a standard set of measures to track performance and compare results across states. North Carolina currently participates in surveys specifically related to members with intellectual and developmental disabilities. The NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services (MHDDSAS) works with NCI to determine which surveys will be conducted in NC each year. Surveys may include the In-Person Survey or mailed surveys (Family/Guardian Survey, Adult Family Survey, and Child Family Survey). Areas addressed by NCI include employment, rights, community inclusion, service planning, choice, and health and safety. For more information on NC’s performance and reports please visit the NCI page at the Division of MHDDSAS or the National Core Indicators® website.
 


Perceptions of Care Survey

Perceptions of Care Surveys are administered annually to individuals and families who have received Medicaid or State-funded mental health and/or substance abuse services.  This survey was administered electronically, by paper, and by interview. It includes questions about access to services, cultural sensitivity, treatment planning, outcomes, social connectedness, and overall satisfaction. 


Provider Satisfaction Surveys

Provider Satisfaction Surveys are conducted annually by DHB. These surveys help to determine areas that need improvement within the network and assess provider satisfaction with Trillium and our processes.


National Committee for Quality Assurance (NCQA) Accreditation

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website contains information to help members, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter (@ncqa), on Facebook, and on LinkedIn.

Trillium was granted full three-year accreditation. Full accreditation indicates that Trillium’s quality improvement and member protection programs meet or exceed NCQA standards.

NCQA logo


External Quality Reviews (EQR)

The North Carolina Department of Health and Human Services (NCDHHS) contracts with an external quality review organization (EQRO) to conduct the annual external quality review (EQR) of Trillium.

The EQRO conducts the annual review jointly with the NCDHHS Intradepartmental Monitoring Team (IMT), which consists of staff members from the Division of Health Benefits (DHB) and the Division of Mental Health, Developmental Disabilities, and Substance Abuse (DMH).

The annual review includes two phases: a desk review of key documents and an on-site review of administrative and clinical operations. The current EQRO for NCDHHS is the Carolinas Center for Medical Excellence (CCME).

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