PerformCareå¨

What PerformCareå¨ does

PerformCare is a Managed Behavioral Health Organization (MBHO) that administers behavioral health and human services on behalf of state Medicaid programs in Pennsylvania and New Jersey. Operating as a subsidiary within the AmeriHealth Caritas Family of Companies, the company contracts directly with state Medicaid agencies and receives capitation payments to manage mental health, substance use treatment, crisis services, and children and youth services for enrolled Medicaid members. The company holds NCQA Full Accreditation for Medicaid and NCQA Health Equity Accreditation for Pennsylvania operations.

The core operational platform consists of a member-facing portal for claims access, health information review, and self-management wellness tools; a provider-facing portal integrated with NaviNet for electronic claims submission, prior authorization, credentialing, and care coordination; and curated recommendations for third-party behavioral health tracking mobile applications. Care management services include discharge planning, peer support, treatment monitoring, and intensive behavioral health services (IBHS) and family-based mental health services (FBMHS). Specialized programs include the New Jersey Children's System of Care, a distinct sub-brand operating at performcarenj.org.

PerformCare's revenue model is government capitation: the company is paid a fixed per-member-per-month rate by state Medicaid programs and bears utilization risk for the behavioral health services its enrolled members consume. Distribution to members is via Medicaid enrollment and member portals, while distribution to providers occurs through credentialing into the PerformCare network. A Philadelphia Market Expansion office and a "Commercial sector" solutions page indicate some intent to broaden the contract base beyond the current two-state Medicaid footprint, though no new contracts are publicly disclosed.

Name

PerformCareå¨

Legal name

PerformCare

Website

https://performcare.org

Company type

Private

Founded year

2009

Operating status

Operating

Headcount range

11–50 employees

Short description

PerformCare is a Medicaid Managed Behavioral Health Organization and subsidiary of AmeriHealth Caritas that administers behavioral health, substance use, and children and youth services for Medicaid members in Pennsylvania and New Jersey under capitated state contracts.

Ownership category

akta.pro rank

Product category

Medicaid Managed Behavioral Healthcare

NAICS

Offices of Physicians, Mental Health Specialists (621112), Individual and Family Services (6241), Services for the Elderly and Persons with Disabilities (624120)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000), Services-Social Services (8300)

akta.pro primary industry

Behavioral Health Care Management & Case Management (HLAEAHAE)

akta.pro secondary industries

Behavioral Health Benefit Administration (MBHO Core) (HLAEAHAA), Behavioral Health Utilization Management & Care Authorization (HLAEAHAD), Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)

Keywords

• Medicaid managed care
• Behavioral health services
• Managed care organization
• Mental health services
• Care coordination

Headquarters

HQ city

Harrisburg

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Medicaid Managed Care Capitation: PerformCare generates revenue as a Managed Behavioral Health Organization (MBHO) contracted by state Medicaid programs. The company receives capitation payments per enrolled member to manage behavioral health care services for Medicaid recipients in Pennsylvania and New Jersey.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels5 records

Core offering

PerformCare is a Medicaid Managed Behavioral Health Organization (MBHO) that contracts with state Medicaid programs in Pennsylvania and New Jersey to manage behavioral health care for Medicaid enrollees. The company delivers mental health services, substance use treatment, children and youth behavioral health services (including the New Jersey Children's System of Care), care coordination, crisis intervention, and wellness programs through a contracted provider network and in-house care management. Members access services via member and provider portals, mobile tools, and a 24/7 member support infrastructure.

Product overview

PerformCare operates as a Medicaid managed behavioral health care organization offering a unified platform of member and provider services. The core offerings include a member portal for claims viewing and health information access, provider self-service tools including NaviNet for claims and billing, and comprehensive behavioral health care services spanning outpatient therapy to intensive behavioral health services. The company also provides self-management wellness resources including screening tools and recommended third-party treatment-monitoring apps for conditions like depression, anxiety, bipolar disorder, and eating disorders. Services are available for both adults and children/youth, with specialized New Jersey Children's System of Care as a distinct program offering.

Differentiator

Problem solved

Functional benefit

Products and services

• Managed Behavioral Health Care Services (Pennsylvania) Managed behavioral health care services delivered to Pennsylvania Medicaid enrollees, including outpatient therapy, intensive behavioral health services (IBHS), family-based mental health services (FBMHS), inpatient care coordination, mental health and substance use treatment.
• New Jersey Children's System of Care System of care coordination services specifically designed for children and youth in New Jersey, providing coordinated behavioral health and support services including children's legal rights advocacy, family-based mental health services, and intensive behavioral health services.
• Care Management Services Care coordination and management services for members including discharge planning, peer support, and treatment monitoring for individuals with complex behavioral health needs.
• Public Sector Managed Care Solutions Customized behavioral health managed care solutions tailored for public sector health programs and state Medicaid agencies seeking outsourced management of behavioral health benefits.
• Commercial Sector Behavioral Health Solutions Customized behavioral health managed care solutions tailored for commercial sector employers, health plans, and organizations seeking behavioral health benefit management and wellness programming.

Quantifiable outcome

• NCQA Full Accreditation for Medicaid achieved — highest accreditation status from NCQA

Named customers3 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

One partnership is on record.

• AmeriHealth CaritascoreStrategic or Co-development PartnerPerformCare is an affiliated health plan company within the AmeriHealth Caritas Family of Companies, operating as the behavioral health care subsidiary. AmeriHealth Caritas is a national leader in Medicaid managed care, and PerformCare provides managed behavioral health care services under this umbrella, including for New Jersey Children's System of Care and Pennsylvania managed behavioral health care programs.

Scale indicators1 record

Recent moves6 records

Expansion highlights5 records

Direct peers

• Carelon Behavioral Health (formerly Beacon Health Options): One of the largest managed behavioral health organizations in the U.S., contracting with state Medicaid agencies and commercial payers to administer behavioral health benefits. Direct competitor to PerformCare in the Medicaid MBHO space, including in PA and NJ procurements.
• Optum Behavioral Health: Operates one of the nation's largest behavioral health networks and manages Medicaid and commercial behavioral health benefits. Competes head-to-head with PerformCare for state Medicaid contracts and provider network participation.
• Magellan Health (Centene): Specialty managed care company focused on behavioral health, special populations, and Medicaid managed care, now part of Centene. Closely comparable to PerformCare in serving state Medicaid behavioral health carve-outs and complex populations.
• New Directions Behavioral Health: Managed behavioral health care organization serving Medicaid, commercial, and public sector clients with utilization management, care coordination, and provider network services — directly comparable to PerformCare's MBHO operating model.
• Cenpatico (Centene subsidiary): Specialty MBHO within Centene providing behavioral health managed care for Medicaid and CHIP populations in multiple states. Directly comparable Medicaid MBHO model and population focus as PerformCare.

Broad incumbents

• AmeriHealth Caritas (parent): Parent organization and national Medicaid managed care plan serving multiple states. While broader than PerformCare's behavioral-health-only scope, it shares the same Medicaid managed care chassis, regulatory framework, and operational infrastructure.
• UnitedHealth Group / Optum: Diversified managed care and health services conglomerate with significant behavioral health exposure through Optum. Competes broadly with PerformCare in state Medicaid procurements and provider network contracting.
• Elevance Health (Anthem): Large national managed care company with Medicaid plans (Anthem Blue Cross Blue Shield state plans) and behavioral health capabilities. Competes with PerformCare in integrated Medicaid procurements across PA and adjacent states.
• Centene Corporation: Largest Medicaid managed care organization in the U.S., operating state health plans and specialty MBHOs (Magellan, Cenpatico). Direct competitor to PerformCare's parent in state Medicaid contracts and behavioral health carve-outs.

Regional players

• PerformCare NJ (Children's System of Care) — Mercer, Camden, Statewide CSOC Operators: Regional comparators include other Children's System of Care contractors and county-based behavioral health managed care operators in NJ and PA — entities that compete for or partner with state agencies on similar youth behavioral health carve-outs.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/performcarepa
• LinkedInlinkedin.com/company/cbhnp

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

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 PerformCareå¨