Strategic Planning & Outcomes
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.
Trillium works to help every person we serve get the culturally appropriate services they need to improve their 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.
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.
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.
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).
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 members achieving realistic health goals, rather than payments based on number of visits. Visit our page for more information.
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.
The annual Trillium Health Resources Quality Management and Improvement Program (QMIP) outlines how our responsibility to members, providers/practitioners, stakeholders and community partners will be fulfilled. It frames the purpose of the QMIP 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. Trillium establishes agency-wide goals that are measured and reported routinely to the Trillium Health Resources Quality Improvement Committee.
The QMIP is supported by the Quality Assurance and Performance Improvement (QAPI) Work Plan which includes Performance Improvement Projects (PIPs), Provider Support Plan, Member Incentive Programs, annual reports and other quality related activities. We review and revise the QMIP based on an annual evaluation of our QAPI Work Plan.
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 the 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® 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 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 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.
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.
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).
