WellCare Health Plans, Inc., Community Care of North Carolina, Inc. (CCNC) and Community Care Physicians Network, LLC (CCPN) have agreed to collaborate on the delivery of high-quality healthcare to North Carolina’s Medicaid beneficiaries in connection with North Carolina’s new Medicaid program that is expected to be implemented in 2019.
CCNC subsidiary North Carolina Community Care Networks manages healthcare services for approximately 1.7 million North Carolina Medicaid enrollees through regional healthcare networks serving all 100 counties in the state. CCNC has established relationships with every hospital in the state, thousands of private practice physicians (including those in the CCPN network), every county health department, the state’s 34 federally qualified health centers and 27 rural health centers. Regional CCNC program networks also employ roughly 600 care managers who work closely with North Carolina Medicaid beneficiaries and providers to ensure complex medical needs are appropriately managed.
WellCare is a leading provider of managed care services for government-sponsored healthcare programs including serving more than 2.7 million Medicaid beneficiaries across 11 states. WellCare and CCNC intend to coordinate care through joint development and management of population health programs, predictive analytics solutions and care management models for North Carolina Medicaid enrollees with a particular focus on those with complex health problems. WellCare and CCNC intend to leverage CCPN’s robust network of primary care physicians to deliver clinical services to WellCare’s members. Additionally, CCPN intends to provide infrastructure, provider relationships and support processes, while WellCare brings managed care operational best practices, innovative payment models and comprehensive clinical supports.
“We’re excited by WellCare’s vision and commitment to health system transformation and look forward to partnering with them to continue our mission to improve care for North Carolinians,” said L. Allen Dobson, Jr., M.D., CCNC president and CEO. “CCNC is ready to partner with health plans such as WellCare that are committed to improving healthcare quality and access to care and building on our strong provider infrastructure in North Carolina.”
“For years, CCNC has provided high-quality healthcare to North Carolinians. Together, we will build on this strong foundation to improve health outcomes while controlling costs,” said Gregg MacDonald, senior vice president, division president at WellCare. “Our combined expertise offers Medicaid managed care services and clinical excellence, and importantly, an unwavering dedication to delivering the best possible healthcare to the state’s most vulnerable populations.”
Unique to this arrangement, WellCare brings its community advocacy program, which identifies local, community-based solutions to address unmet social support needs. WellCare, in conjunction with CCNC, intends to establish a community advocacy program tailored to North Carolina Medicaid beneficiaries to connect them to essential and needed social support services.
“We know that people cannot prioritize their health when their basic social needs are not being met,” said Pamme Taylor, WellCare’s vice president for advocacy and community-based programs. “By helping people address these needs, we hope to help people lead better, healthier lives, provide greater support for North Carolina’s social safety net, and reduce the overall cost of healthcare.”
