Vaya Health

What Vaya Health does

Vaya Health is a Local Management Entity/Managed Care Organization (LME/MCO) and publicly governed behavioral healthcare entity based in Asheville, North Carolina, that manages publicly funded mental health, substance use disorder, intellectual and developmental disability (I/DD), and traumatic brain injury (TBI) services. The company operates three core health plans: Vaya Total Care (a Medicaid Behavioral Health and I/DD Tailored Plan integrating physical health, pharmacy, and behavioral health), State-Funded Services (for uninsured or underinsured individuals at or below 300% of the federal poverty level), and NC Medicaid Direct (behavioral health coverage for Medicaid beneficiaries not enrolled in managed care). Members access services through a contracted provider network across 32 North Carolina counties, with the pending Partners Health Management merger (effective October 1, 2026) expanding coverage to 47 counties and over 222,000 members.

The organization's technology stack is centered on web-based portal infrastructure rather than proprietary AI or data platforms. Core systems include the Member and Recipient Portal (account access, PCP changes, appeals/grievances, health screening), Provider Central (authorization, pharmacy prior authorization, provider resources), a digital Care Management Referral System, and the Referral Screening Verification Process (RSVP) for the Transitions to Community Living program. Vaya contracts with Navitus Health Solutions for pharmacy benefit management and Modivcare for non-emergency medical transportation. Service delivery is supported by Tailored Care Management through Advanced Medical Homes Plus, Care Management Agencies, and Vaya's own Care Management Department, plus crisis infrastructure including a 24/7 Behavioral Health Crisis Line, mobile crisis services, and walk-in crisis centers.

Vaya's revenue model is entirely government-dependent: capitated payments from the North Carolina Department of Health and Human Services (NCDHHS) for Medicaid managed care, supplemented by state appropriations, federal block grants, and county government funding for state-funded services. Members do not pay premiums; adult Medicaid members face a standard $4 prescription copay with broad exemptions. The company serves members across multiple segments including Tailored Plan enrollees with serious mental illness, severe SUD, I/DD or TBI; NC Medicaid Direct members; state-funded services recipients; Transitions to Community Living participants; and Money Follows the Person participants (where Vaya operates statewide across all 100 NC counties). Leadership is headed by Brian Ingraham as Chief Executive Officer and President. The company holds NCQA Health Plan Accreditation (2025) and the Gold-level Bell Seal for Workplace Mental Health (2026).

Name

Vaya Health

Legal name

Vaya Health

Website

https://vayahealth.com

Company type

Private

Founded year

2011

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Vaya Health is a publicly governed North Carolina LME/MCO that manages Medicaid and state-funded behavioral health, I/DD, and TBI services across 32 counties (47 post-merger), serving Medicaid beneficiaries and uninsured residents through capitated contracts with NCDHHS.

Ownership category

akta.pro rank

Product category

Medicaid Managed Behavioral Healthcare

NAICS

Health Care and Social Assistance (62)

SIC

Services-Health Services (8000)

akta.pro primary industry

Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)

akta.pro secondary industries

Behavioral Health Managed Care (Medicaid) / BH Carve-In-Carve-Out Plans (HLAEAEAE), Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ), Medicaid Managed Care HMOs (HLAEAMAI)

Keywords

• Medicaid managed care
• Behavioral health services
• Managed care organization
• Developmental disability services
• Mental health services

Headquarters

HQ city

Asheville

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Supply Chain

Revenue model

1. Medicaid Capitation Payments: Vaya Health receives capitated payments from the North Carolina Department of Health and Human Services (NCDHHS) to manage behavioral health, I/DD, and TBI services for Medicaid beneficiaries enrolled in Vaya Total Care (Tailored Plan) and NC Medicaid Direct. Payments cover physical health, pharmacy, and behavioral health services under managed care arrangements.
2. State-Funded Services: State-funded services are financed through state appropriations from North Carolina, federal block grants, and county governments. These funds support behavioral health and I/DD services for uninsured or underinsured individuals who do not qualify for Medicaid.

Pricing tiers

Go-to-market motion1 record

Distribution channels7 records

Marketing channels9 records

Core offering

Vaya Health operates as a Local Management Entity/Managed Care Organization (LME/MCO) under contract with the North Carolina Department of Health and Human Services, managing publicly funded behavioral health, intellectual/developmental disability (I/DD), and traumatic brain injury (TBI) services across 32 North Carolina counties. It sells three core health plans—Vaya Total Care (a Medicaid Behavioral Health and I/DD Tailored Plan), State-Funded Services for uninsured individuals, and NC Medicaid Direct for non-managed-care beneficiaries—along with integrated care management, pharmacy benefits, transportation, housing programs, and 24/7 crisis services.

Product overview

Vaya Health is a behavioral health managed care organization operating as a Local Management Entity/Managed Care Organization (LME/MCO) in North Carolina. The company offers a multi-plan portfolio centered on three core health plans: Vaya Total Care (a Behavioral Health and I/DD Tailored Plan for Medicaid members), State-Funded Services (for uninsured/underinsured individuals), and NC Medicaid Direct (for Medicaid beneficiaries not in managed care). These plans provide comprehensive behavioral health, substance use disorder, intellectual/developmental disability, and traumatic brain injury services. The product ecosystem includes integrated modules for Tailored Care Management, Pharmacy Services (via Navitus Health Solutions), Transportation Assistance (via Modivcare), Housing Initiatives (including Transitions to Community Living, Money Follows the Person, and multiple housing support programs), and value-added perks through Vaya Total Care Perks. Members access services through web-based portals including the Member and Recipient Portal and Provider Central, supported by 24/7 crisis services, mobile crisis units, and walk-in centers. The company serves 32 counties in North Carolina with a pending merger with Partners Health Management (effective October 2026) that will expand coverage to 47 counties and 222,000+ members.

Differentiator

Problem solved

Functional benefit

Brands

• Vaya Total Care: Behavioral Health and I/DD Tailored Plan for Medicaid members focusing on whole-person care including physical health, pharmacy, behavioral health, I/DD, and TBI services.
• WNC Thrive

Products and services

• Vaya Total Care (Tailored Plan) A Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan for NC Medicaid members with serious mental health conditions, severe substance use disorders, I/DD, or traumatic brain injuries. Provides integrated physical health, pharmacy, behavioral health, I/DD, and TBI services with no additional premium for eligible Medicaid members (standard $4 prescription copay for adults).
• State-Funded Services Services for uninsured or underinsured individuals who cannot afford to pay for care, with eligibility based on household income not exceeding 300% of the federal poverty level. Provides mental health, substance use disorder, I/DD, and TBI services funded by North Carolina state appropriations, federal block grants, and county governments.
• NC Medicaid Direct Behavioral health, substance use disorder, I/DD, and TBI services for NC Medicaid beneficiaries not enrolled in a managed care plan (not in Tailored Plan, Standard Plan, or Eastern Band of Cherokee Indians Tribal Option). Includes children in foster care, dual-eligible members, and former foster care youth. Physical health and pharmacy are covered separately by NC Medicaid Direct.
• Tailored Care Management A free care management service providing dedicated care managers for members with mental health needs, substance use disorders, I/DD, or TBI. Care managers collaborate with members, care teams, and families to create health goals, connect to needed services, and deliver ongoing care coordination. Delivered through Advanced Medical Homes Plus (AMH+), Care Management Agencies (CMA), and Vaya's internal Care Management Department.
• Transitions to Community Living (TCL) Program providing eligible adults with serious mental illness the opportunity to choose where they live and work. Connects participants to mental and physical health care services, housing supports, and community resources to maintain a home in their own name. Participants must be NC Medicaid beneficiaries or have monthly income of $2,000 or less.
• Money Follows the Person (MFP) Statewide program helping older adults (55+) and people with physical disabilities (18+) who have lived in skilled nursing facilities for at least 60 consecutive days transition back to community living. Vaya operates this program on behalf of NCDHHS across all 100 North Carolina counties. Includes transition coordination, housing assistance, community reintegration support, and home modifications.
• Housing Initiatives Portfolio of housing support programs for Vaya members, including the Transitions to Community Living Voucher, Permanent Supportive Housing, Non-Medicaid Residential Services, Housing Supports Grant, Vaya Independence Project, Back@Home programs, and Justice Reentry Program. Addresses housing instability, homelessness, and reintegration needs for behavioral health and I/DD populations.
• Transportation Assistance Non-Emergency Medical Transportation (NEMT) and non-medical transportation services for Vaya Total Care members to and from Medicaid appointments, pharmacies, and community resources. Provided through a partnership with Modivcare at no cost to eligible members, including non-medical transportation as a Vaya Total Care Perk.
• Pharmacy Services Pharmacy benefit management for Vaya Total Care members administered through Navitus Health Solutions. Covers prescription drugs, over-the-counter medicines, insulin, diabetic supplies, smoking cessation agents, and emergency contraception. Includes pharmacy network access, medication formulary management, prior authorization processing, and clinical pharmacy services such as drug interaction reviews.
• Mental Health Services Comprehensive mental health services including outpatient counseling, psychiatric medication management, peer support, Assertive Community Treatment (ACT), Community Support Teams, inpatient care, crisis care, and residential care. Includes free, confidential online mental health screening tools to help individuals assess symptoms and determine if professional help is needed.
• Substance Use Disorder Services Treatment services for substance use disorders including individual and group counseling, medication-assisted treatment (MAT), outpatient services, residential programs, detox centers, and recovery support. Includes specialized opioid misuse prevention and treatment programs and recovery support services.
• 1915(i) Home and Community-Based Services Medicaid home and community-based services helping individuals live at home, find jobs, learn skills, and participate in their communities. Includes Community Transition, Supported Employment, Individual and Transitional Support, and Community Living and Support services.
• Vaya Total Care Perks Value-added perks and incentives for qualified Vaya Total Care Medicaid members at no cost. Includes meal delivery via Mom's Meals after qualifying hospital discharge, WeightWatchers app voucher (BMI 25+), breast pumps via Aeroflow, GED education vouchers via GEDWorks, Simply Home safety equipment discounts, and non-medical transportation.
• Member and Recipient Portal Secure online portal providing Vaya members and recipients with account access, primary care provider change requests, forms, appeals and grievances submission, and health screening tools. Available in English and Spanish.
• Provider Central Dedicated provider portal for Vaya's network providers to access authorization information, pharmacy prior authorization, and provider resources. Used by behavioral health providers, pharmacies, and other network partners across the 32-county service area.
• Crisis Services Behavioral health crisis services including a 24/7 Behavioral Health Crisis Line (1-800-849-6127), Mobile Crisis Services, and Walk-in Crisis Centers offering same-day crisis assessments for individuals experiencing behavioral health emergencies.
• System of Care Service model supporting children and youth receiving behavioral health services by coordinating community-based services including those provided by Vaya and through schools, juvenile justice, child welfare, and other state agencies. Includes dedicated youth and family support pathways.
• WNC Thrive Hurricane Helene recovery program expanding resources for children, youth, and families affected by the storm. Helps young people heal, reconnect, and thrive through safe, supportive, engaging activities at no cost to families in Western North Carolina.

Quantifiable outcome

• 222,000+ members served post-merger across 47 North Carolina counties
• +1 more outcomes

Named customers1 record

Segments5 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

16 partnerships are on record, tiered core and minor.

• Partners Health ManagementcoreStrategic or Co-development Partner · 22 May 2026Vaya Health and Partners Health Management received approval from North Carolina's Department of Health and Human Services to merge, effective October 1, 2026. The combined organization will operate as Vaya Partners and become North Carolina's largest publicly governed behavioral healthcare entity, serving more than 222,000 members across 47 counties. The merger consolidates two long-established LME/MCOs that manage publicly funded mental health, substance use, and disability services.
• Crossroads Treatment CenterscoreStrategic or Co-development Partner · 9 April 2026Crossroads Treatment Centers launched a mobile addiction treatment unit in rural Western North Carolina, partnering with Newdale Church and supported by Vaya Health and NCDHHS. The mobile unit delivers medication-assisted treatment, counseling, and recovery support directly to underserved communities within a 40-mile radius of Weaverville, addressing transportation, access, and stigma barriers heightened after Hurricane Helene.
• Newdale ChurchminorStrategic or Co-development Partner · 9 April 2026Community partner host site for the mobile addiction treatment unit operated by Crossroads Treatment Centers in rural Western North Carolina. The church provides a accessible location for delivering medication-assisted treatment and counseling services to underserved communities.
• Navitus Health SolutionscoreTechnology or IntegrationVaya Health works with Navitus Health Solutions as its Pharmacy Benefit Manager to help members access prescription medications. The partnership provides pharmacy network access, medication formulary management, prior authorization processing, and clinical pharmacy services including drug interaction reviews.
• ModivcarecoreTechnology or IntegrationVaya Health partners with Modivcare to manage transportation services including Non-Emergency Medical Transportation (NEMT) for Medicaid appointments and non-medical transportation as a Vaya Total Care Perk. Modivcare coordinates free rides for eligible members to medical visits, pharmacies, and community resources.
• AeroflowminorChannel Partner/ Reseller/ DistributorAeroflow provides breast pumps and lactation support services to eligible Vaya Total Care members as part of the Pregnancy Support Perks program. Members can select a breast pump through Aeroflow's website and receive education and support through Lactation Link by Aeroflow Breastpumps.
• GEDWorksminorChannel Partner/ Reseller/ DistributorGEDWorks provides GED education and test preparation services to eligible Vaya Total Care members. The program offers one-on-one bilingual advising, study materials in English or Spanish, GED-Ready practice tests, expert tutors, and a test-pass guarantee for members seeking high school equivalency diplomas.
• Simply HomeminorChannel Partner/ Reseller/ DistributorSimply Home provides home safety and assistance equipment discounts for Vaya Total Care members with intellectual/developmental disabilities. Products include home sensors, environmental controls, electronic medication dispensers, personal emergency devices, and video monitoring equipment.
• Mom's MealsminorChannel Partner/ Reseller/ DistributorMom's Meals provides home-delivered meal services for Vaya Total Care members discharged from qualifying inpatient hospital stays. Eligible members may receive two free meals per day for up to seven days in the first month after discharge to support recovery.
• WeightWatchersminorChannel Partner/ Reseller/ DistributorWeightWatchers provides a mobile app subscription voucher for eligible Vaya Total Care members with BMI of 25 or higher. The program offers food/activity tracking, fitness classes, sleep tracking, social community support, and wellness rewards to support healthy eating patterns and weight loss.
• Community Care of North Carolina (CCNC)coreTechnology or IntegrationCCNC provides care management for NC Medicaid Direct members whose primary needs are related to physical health. Vaya works with CCNC to coordinate care management services, ensuring members receive appropriate physical and behavioral health services.
• Prime TherapeuticscoreTechnology or IntegrationPrime Therapeutics serves as the Pharmacy Benefit Administrator for NC Medicaid Direct members, managing prescription drug benefits including medication coverage, prior authorizations, and pharmacy network access for members not enrolled in Vaya Total Care.
• QuitlineNCminorChannel Partner/ Reseller/ DistributorQuitlineNC provides free tobacco cessation services to any North Carolina resident, including Vaya members. Services include 24/7 support through 1-800-QUIT-NOW, with interpretation services available for many languages to help people quit tobacco products.
• Eastern Band of Cherokee Indians (EBCI) Tribal OptioncoreTechnology or IntegrationEBCI Tribal Option provides care management for federally recognized tribal members or those eligible for services through the U.S. Indian Health Service. The program is available primarily in five counties (Cherokee, Graham, Haywood, Jackson, Swain) with opt-in available in six additional counties (Buncombe, Clay, Henderson, Macon, Madison, Transylvania).
• North Carolina Department of Health and Human Services (NCDHHS)coreStrategic or Co-development PartnerNCDHHS is the state agency that oversees the Medicaid program, regulates LME/MCOs, and contracts with Vaya Health to manage behavioral health, I/DD, and TBI services. NCDHHS approved the merger with Partners Health Management and selected Vaya as the NC ROOTS Hub Lead for Region 3 to strengthen rural health across 12 counties.
• North Carolina Rural Organizations Orchestrating Transformation for Sustainability (NC ROOTS)coreStrategic or Co-development PartnerVaya Health was selected by NCDHHS as the NC ROOTS Hub Lead for Region 3, a program designed to strengthen rural health across 12 counties in Western North Carolina through coordination and transformation initiatives.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Sandhills Center: NC LME/MCO serving the Sandhills region of central NC, providing behavioral health, I/DD, and substance use services. Comparable in regulatory structure, capitated Medicaid revenue model, and member base characteristics.
• Easterseals PORT Health: NC-based behavioral health and I/DD provider serving multiple counties with outpatient, residential, and community-based services. Comparable to Vaya in target population (SMI/SUD/I/DD) and NC operating region, though operates as a provider rather than an MCO.
• Trillium Health Resources: NC LME/MCO covering eastern North Carolina, managing Medicaid behavioral health, I/DD, and TBI services under the same Tailored Plan framework as Vaya. Direct state-level peer with comparable regulatory model and capitated revenue.
• Partners Health Management: NC-based LME/MCO that manages publicly funded behavioral health, I/DD, and TBI services in 27 counties. About to merge with Vaya to form Vaya Partners, making it the single most directly comparable peer.
• Alliance Health: NC LME/MCO serving central North Carolina counties, managing publicly funded behavioral health and I/DD services. Operates under identical NCDHHS oversight and Tailored Plan structure as Vaya.

Broad incumbents

• Centene Corporation: Largest U.S. Medicaid managed care insurer with significant behavioral health exposure through subsidiaries. Operates in NC's Standard Plan market and competes with LME/MCOs for broader Medicaid contracts. Comparable capitation model and Medicaid focus.
• Elevance Health (Anthem): Major U.S. health insurer with substantial Medicaid managed care presence through Anthem Blue Cross Blue Shield plans. Operates in NC's Standard Plan market with comparable integrated care capabilities. Larger portfolio but overlapping Medicaid MCO business.
• Magellan Health: Centene-owned behavioral health managed care specialist managing BH/SUD benefits for health plans and state Medicaid programs nationwide. Comparable specialty BH managed care capabilities and capitated revenue model, though national rather than NC-focused.
• Molina Healthcare: National Medicaid-focused managed care company with significant BH/I/DD managed care exposure across multiple states. Operates in NC's Standard Plan market and competes for integrated Medicaid contracts. Comparable member populations and capitated revenue model.
• UnitedHealth Group (Optum): Largest U.S. health insurer with Optum's massive behavioral health platform and growing Medicaid presence. Operates UnitedHealthcare Community Plan in NC and provides integrated BH/I/DD services nationwide. Broader portfolio but overlapping Medicaid managed care capabilities.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/VayaHealth
• Facebookfacebook.com/VayaHealth

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Vaya Health