Chorus Community Health Plan

What Chorus Community Health Plan does

Chorus Community Health Plans (CCHP) is a Wisconsin Medicaid Managed Care Organization headquartered in Milwaukee, Wisconsin, and an affiliate of Children's Wisconsin. Founded in 2006 and operating as a private, for-profit entity, CCHP administers BadgerCare Plus (Wisconsin Medicaid) coverage for more than 124,000 adults and families across 68 of Wisconsin's 72 counties. The plan also administers Care4Kids, a care coordination program for children in out-of-home care that expanded statewide as of January 2026 to include Former Foster Care Youth up to age 26 and children of enrolled members. Core revenue is generated through capitation payments received from the Wisconsin Department of Health Services in exchange for delivering preventive, physical, dental, vision, and behavioral health coverage; CCHP exited the ACA Marketplace effective January 1, 2026, terminating its Individual and Family Plan line.

CCHP's technology stack includes the CCHP Provider Portal (claims, eligibility, appeals, remits, in-portal messaging), the GuidingCare Auth Portal for prior authorizations (replacing the legacy CareWeb platform in March 2024), and the member-facing Wellness Portal (powered by PDHI) where members complete wellness activities, track incentive points, and redeem gift cards from Walmart, Target, and Amazon. Provider credentialing is performed by Symplr Payer as the NCQA-certified Credentialing Verification Organization, and as of January 1, 2026 Network Health became the sole Third-Party Administrator for claims and customer service across all lines of business, using payer ID 29123 with electronic claims routed through SDS Clearinghouse. Supplemental services are delivered via partner integrations including Freespira (FDA-cleared digital therapeutic for panic attacks/PTSD), Foodsmart (telenutrition), Nystrom & Associates (telepsychiatry), Hayat Pharmacy (asthma support), MTM Health/Veyo (transportation), Dental Professionals of Wisconsin, and Herslof Optical Company.

The go-to-market motion is community- and state-led rather than commercial: enrollment flows exclusively through Wisconsin DHS via ACCESS.wi.gov, the MyACCESS mobile app, and the 2-1-1 helpline. Member engagement is driven by Member Advocates, the Community Engagement Team (health fairs, farmers markets, educational workshops), and the wellness incentive program. NCQA accreditation and NCQA Health Equity accreditation underpin the regulatory moat, while the Children's Wisconsin affiliation provides brand credibility and clinical infrastructure.

Name

Chorus Community Health Plan

Legal name

Chorus Community Health Plans

Website

https://chorushealthplans.org

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

251–500 employees

Short description

Chorus Community Health Plans (CCHP) is a Wisconsin Medicaid Managed Care Organization that administers BadgerCare Plus coverage for 124,000+ members across 68 of 72 Wisconsin counties, including the Care4Kids program for foster children, and operates as an affiliate of Children's Wisconsin.

Ownership category

akta.pro rank

Product category

Medicaid Managed Care

SIC

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

akta.pro primary industry

Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ)

Keywords

• Medicaid managed care
• BadgerCare Plus coverage
• Health insurance plans
• Care coordination services
• Foster care healthcare

Headquarters

HQ city

Milwaukee

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. BadgerCare Plus Capitation Payments: CCHP operates as a Wisconsin Medicaid Managed Care Organization receiving capitation payments from the state of Wisconsin (via the Department of Health Services) in exchange for providing comprehensive health coverage to BadgerCare Plus enrollees. Services covered include preventive, physical, dental, and behavioral health. The program is described as little or no cost to eligible members.
2. Care4Kids Program: CCHP delivers care coordination for children in out-of-home care (foster care) through the Care4Kids program, administered in partnership with Wisconsin DHS. As of January 1, 2026, eligibility expanded to include Former Foster Care Youth (up to age 26) and children of enrolled Care4Kids members.
3. Discontinued Individual and Family Plans (IFP): CCHP previously offered ACA Marketplace Individual and Family Plans, generating premium revenue from enrolled individuals and families. This line of business was discontinued effective January 1, 2026, with CCHP exiting the ACA Marketplace. Claims for services rendered on or before December 31, 2025 will be processed through July 1, 2026.

Pricing tiers

Go-to-market motion2 records

Distribution channels6 records

Marketing channels7 records

Core offering

Chorus Community Health Plans (CCHP) is a Wisconsin Medicaid Managed Care Organization that delivers BadgerCare Plus health coverage to income-eligible Wisconsin residents across 68 counties. The plan covers preventive, medical, dental, vision, and behavioral health services and operates the Care4Kids care coordination program for children in foster care. CCHP is an affiliate of Children's Wisconsin and provides member-facing tools such as a Wellness Portal with incentive rewards and the Freespira digital therapeutic for panic disorder and PTSD.

Product overview

Chorus Community Health Plans (CCHP) operates as a Wisconsin Medicaid Managed Care Organization offering a portfolio of health coverage products centered on BadgerCare Plus and Care4Kids. BadgerCare Plus provides comprehensive Medicaid coverage for individuals and families meeting income requirements, while Care4Kids offers specialized care coordination for children in foster care. CCHP's member-facing ecosystem includes a Wellness Portal for incentive-based health activities, a Provider Finder Tool for network provider search, and Member Advocate Services for care navigation. Provider-facing tools include the GuidingCare Auth Portal for prior authorizations and the CCHP Provider Portal for claims management. Specialized programs include the Freespira digital therapeutic for behavioral health and integrated dental coverage. The organization also offers Care Management Programs for chronic conditions including asthma, diabetes, and prenatal care.

Differentiator

Problem solved

Functional benefit

Brands

• BadgerCare Plus: Wisconsin Medicaid program health coverage offered by CCHP for individuals and families who meet income requirements.
• Care4Kids
• Healthy Mom, Healthy Baby

Products and services

• BadgerCare Plus Wisconsin Medicaid managed care health plan providing comprehensive coverage (preventive, medical, dental, vision, and behavioral health services) at little or no cost to income-eligible Wisconsin residents. Available across 68 of 72 Wisconsin counties.
• Care4Kids Care coordination program creating a medical home for children in out-of-home care and former foster care youth up to age 26, providing a dedicated Health Care Coordinator, access to Centers of Excellence trained in trauma-informed care, and support across physical, behavioral, and social health needs.
• Care Management Programs Free specialized programs for CCHP members with chronic or complex conditions including asthma, behavioral health, diabetes, prenatal/newborn care, nutrition, and social navigation, providing education, digital tools, personalized support, and incentive points.
• Freespira Treatment Program FDA-cleared digital therapeutic offering a medication-free 28-day home-based treatment for panic attacks, panic disorder, and PTSD, available to all CCHP members.

Quantifiable outcome

• Serving 124,000+ adults and families across 68 Wisconsin counties
• +3 more outcomes

Named customers4 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

Integration3 records

Feature6 records

Partnerships

Eleven partnerships are on record, tiered core and minor.

• Milwaukee County Housing ServicescoreStrategic or Co-development Partner · 1 March 2025CCHP partners with Milwaukee County Housing Services to address homelessness and housing instability. CCHP is one of the earliest healthcare organizations to participate in this program, with $300,000 committed for 2025, bringing cumulative contributions above $2 million.
• Network HealthcoreTechnology or Integration · 1 February 2025Network Health became CCHP's sole Third-Party Administrator (TPA) starting January 1, 2026, providing customer service and claims administration services for all CCHP lines of business. The transition included a new payer ID (29123), new mailing address, and new EFT payment vendors. Effective July 1, 2026, Medicaid claims submitted with an incorrect payer ID will be rejected.
• Nystrom & AssociatescoreStrategic or Co-development Partner · 19 November 2024Nystrom & Associates, a premier provider of behavioral health care services, became an in-network provider for CCHP. The partnership allows CCHP members to access Nystrom's comprehensive telepsychiatry and behavioral health care services as a covered insurance benefit, effective immediately.
• Freespira, Inc.coreTechnology or Integration · 10 February 2021Freespira is the first FDA-cleared digital therapeutic for panic attacks, panic disorder, and PTSD. CCHP partnered with Freespira to offer this medication-free treatment to all members, including Medicaid patients, making CCHP the first health plan to offer this digital treatment in Wisconsin. Treatment is completed in 28 days.
• Dental Professionals of WisconsincoreChannel Partner/ Reseller/ DistributorDental Professionals of Wisconsin (DPoW) administers the dental provider network for CCHP BadgerCare Plus members in the six-county metro region (Kenosha, Milwaukee, Ozaukee, Racine, Washington, Waukesha). Providers can contact DPoW at 414-389-9880 to join the dental network.
• Herslof Optical CompanycoreChannel Partner/ Reseller/ DistributorHerslof Optical Company administers the routine vision provider network for CCHP BadgerCare Plus members. Vision providers can contact Herslof at 414-462-1300 to join the network.
• Symplr PayercoreTechnology or IntegrationSymplr Payer is CCHP's Credentialing Verification Organization (CVO), NCQA-certified, performing primary source verification of practitioner credentials including licenses, education, and certifications. Providers may interact directly with Symplr Payer for credentialing applications while CCHP maintains final credentialing decisions.
• MTM Health (Veyo)minorChannel Partner/ Reseller/ DistributorMTM Health (operating as Veyo in Wisconsin) provides non-emergency medical transportation services for CCHP members to and from healthcare appointments. Contact: 866-907-1493.
• Children's WisconsincoreStrategic or Co-development PartnerCCHP is an affiliate of Children's Wisconsin — one of the most trusted healthcare organizations in Wisconsin. This affiliation provides CCHP with clinical expertise, brand credibility, and infrastructure support. The partnership enables integrated care programs including the Healthy Mom, Healthy Baby program, Care4Kids, and community health initiatives.
• Wisconsin Department of Health Services (DHS)coreStrategic or Co-development PartnerCCHP partners with Wisconsin DHS to deliver BadgerCare Plus coverage. DHS oversees Medicaid eligibility, manages renewals, sets policy requirements, and provides the ForwardHealth infrastructure. CCHP participates in the Care4Kids program administered by DHS.
• Centers of Excellence (Child Welfare Healthcare)coreTechnology or IntegrationCCHP partners with designated Centers of Excellence — medical providers trained in the specific health needs of children in out-of-home care and considered leaders in the healthcare field. These providers are trained in trauma-informed care. The partnership ensures information is shared collaboratively to improve outcomes for children in foster care.

Scale indicators6 records

Recent moves7 records

Expansion highlights6 records

Direct peers

• Group Health Cooperative of Eau Claire: Group Health Cooperative of Eau Claire is a Wisconsin-based cooperative health plan serving western Wisconsin with HMO products including Medicaid. It is a directly comparable regional Wisconsin health plan competing with CCHP in overlapping counties.
• Dean Health Plan: Dean Health Plan is the insurance arm of SSM Health in Wisconsin, offering HMO products including Medicaid managed care. It is a directly comparable Wisconsin provider-affiliated health plan competing with CCHP for Medicaid members and provider relationships.
• Security Health Plan: Security Health Plan is the insurance affiliate of Marshfield Clinic Health System in Wisconsin, offering commercial, Medicare, and Medicaid products. As another provider-affiliated Wisconsin health plan, it mirrors CCHP's structural model and competes for similar Medicaid members.
• Quartz Health Plan: Quartz Health Plan is a Wisconsin-based health insurer offering commercial, Medicare, and Medicaid products through a provider-sponsored model. It is a directly comparable Wisconsin Medicaid MCO competitor to CCHP with overlapping provider networks and similar regional concentration.
• Network Health: Network Health is a Wisconsin-based health insurance company offering Medicare Advantage and individual/family plans, and is now CCHP's Third-Party Administrator. It operates in the same Wisconsin market with overlapping provider networks and serves as both operational partner and competitor in the regional market.
• My Choice Wisconsin: My Choice Wisconsin is a Wisconsin-based Family Care and Medicaid long-term care managed care organization. It is a directly comparable Wisconsin Medicaid MCO serving similar vulnerable populations including those with disabilities and complex care needs.

Broad incumbents

• Molina Healthcare of Wisconsin: Molina Healthcare is a national managed care company focused on government-sponsored healthcare including Medicaid plans in multiple states including Wisconsin. As a Medicaid-specialized incumbent with extensive state-government experience, it competes with CCHP for Wisconsin Medicaid contracts.
• Anthem Blue Cross Blue Shield Wisconsin: Anthem Blue Cross Blue Shield Wisconsin is the state's Blue Cross licensee offering commercial, Medicare, and Medicaid products. As a large diversified incumbent with national scale, it competes with CCHP in Wisconsin Medicaid while also offering adjacent lines of business CCHP has exited.
• Centene Corporation (MHS Health Wisconsin): Centene Corporation operates MHS Health Wisconsin as its state Medicaid plan, and is the largest US Medicaid managed care operator nationally. As the dominant Medicaid-focused incumbent, it competes with CCHP for Wisconsin BadgerCare Plus contracts and brings superior scale and government-program expertise.
• UnitedHealthcare Community Plan of Wisconsin: UnitedHealthcare Community Plan is the Medicaid arm of UnitedHealth Group, one of the largest US health insurers, operating a Wisconsin Medicaid plan. As a national incumbent with massive scale and broad networks, it competes with CCHP for Wisconsin BadgerCare Plus members under the same state contract structure.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/ChorusCommunityHealthPlans
• LinkedInlinkedin.com/company/10881441

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles12 records

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 Chorus Community Health Plan