MCO case managers are not overwhelmed because they lack skill, compassion, or organization.

They are overwhelmed because too many members cycle through preventable crises, and the system often responds too late.

Peer Support, when delivered correctly, is not a “soft service” or a box to check. It is one of the most effective caseload-relief tools available—especially for members with recurring behavioral health, social, or transitional challenges.

For MCO case managers across Edgecombe, Nash, Pitt, Wake, and Halifax counties, understanding how Peer Support actually reduces pressure is critical to improving outcomes and sustainability.

The Hidden Weight of Caseload Pressure

Caseload pressure rarely shows up in reports, but every case manager feels it:

• Repeat crisis calls for the same members
• Escalations after hours or on weekends
• Discharges that fall apart due to lack of follow-through
• Members disengaging, then re-entering the system

Each of these events adds invisible labor—extra calls, documentation, coordination, and emotional strain.

The issue is not that services don’t exist.

The issue is that support often starts too late or without coordination.

This is where Peer Support changes the equation.