Inclusa

What Inclusa does

Inclusa, Inc. is a Wisconsin-based nonprofit Managed Care Organization (MCO) that administers the state's Family Care program, a Medicaid-funded long-term care benefit for frail elders and adults with physical, intellectual, or developmental disabilities. Founded in 2000 as Community Link Incorporated and rebranded to Inclusa on January 1, 2017, the organization serves approximately 15,000-15,500 members across 62 Wisconsin counties. Members are acquired through referrals from Aging and Disability Resource Centers (ADRCs) under a contract with the Wisconsin Department of Health Services that defines capitation, eligibility, and service scope. Inclusa's Commonunity® trademarked model is the framing for person-centered care planning across a catalog of more than 35 service modules covering in-home care, residential placements (AFH, CBRF, RCAC), employment supports, therapy, mental health and AODA services, transportation, home modifications, and assistive technology. Operational infrastructure centers on a Provider Portal for claims and authorization management, Electronic Visit Verification (EVV) for in-home visit documentation, a Member Portal, and a Provider Learning Management System, with a CMS Patient Access API endpoint for interoperability compliance.

The business model is single-payer capitated Medicaid reimbursement. Inclusa receives per-member-per-month payments from Wisconsin Medicaid to coordinate and pay for the long-term care needs of enrolled members, with payment rates and eligibility set by the Department of Health Services. Pricing is not publicly disclosed and member-level costs are determined by program eligibility rather than commercial negotiation. Distribution runs through two channels: direct enrollment via ADRC referrals (a mandated front door for long-term care in Wisconsin) and contracted provider networks that deliver the underlying services. All revenue is exposed to Wisconsin Medicaid policy decisions, capitation rate adjustments, and Family Care program design choices.

In August 2022, Humana Inc. agreed to purchase substantially all of Inclusa's assets, and in June 2023 substantially all Family Care assets were acquired by Independent Care Health Plan (iCare), a Humana subsidiary. Inclusa continues to operate under the Family Care / Inclusa brand with operational independence while integrating with iCare and Humana's broader national Medicaid platform. Current scale is 251-500 employees, a Stevens Point headquarters, and regional offices across Wisconsin, with Mark Hilliker serving as CEO since founding in 2000.

Name

Inclusa

Legal name

Inclusa, Inc.

Website

https://inclusa.org

Company type

Private

Founded year

2000

Operating status

Operating

Headcount range

251–500 employees

Short description

Inclusa is a Wisconsin-based nonprofit Managed Care Organization administering the state's Medicaid Family Care long-term care program for approximately 15,000-15,500 frail elders and adults with disabilities across 62 counties under contract with the Wisconsin Department of Health Services.

Ownership category

akta.pro rank

Product category

Managed Long-Term Care (Medicaid)

NAICS

Services for the Elderly and Persons with Disabilities (624120), Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly (62331), Residential Intellectual and Developmental Disability Facilities (623210), Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities (6232)

SIC

Services-Nursing & Personal Care Facilities (8050), Services-Social Services (8300), Services-Home Health Care Services (8082)

akta.pro primary industry

Affordable / Low-Income Assisted Living (Medicaid Waiver Focused) (HLADABAE)

akta.pro secondary industries

Specialized Assisted Living for Developmental/Intellectual Disabilities (Adult) (HLADABAJ), Behavioral Health–Capable Assisted Living (Mental Health/SUD Support) (HLADABAI), Independent Living with Supportive Services (Light ADL/IADL Support) (HLADAAAE), Respite Care for Adults with Disabilities / Special Needs (HSABAGAI)

Keywords

• Managed long-term care
• Medicaid managed care
• Family care program
• Person-centered services
• Disability support services

Headquarters

HQ city

Stevens Point

HQ country

United States

HQ region

North America

Offices6 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Medicaid Capitated Payments: Inclusa operates under a contract with the Wisconsin Department of Health Services to provide Family Care services. As a managed care organization, they receive capitated (per-person) payments from Medicaid to manage the long-term care needs of eligible members including elders and adults with disabilities.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels5 records

Core offering

Inclusa is a Wisconsin Managed Care Organization that operates the Family Care program, a Medicaid-funded long-term care program for frail elders and adults with intellectual, developmental, or physical disabilities. The organization coordinates person-centered services through an interdisciplinary care team model (Commonunity®) and provides a Self-Directed Supports option, supporting members to live in community settings rather than institutional care.

Product overview

Inclusa is a Wisconsin-based Managed Care Organization (MCO) offering Family Care, a Medicaid-funded long-term care program. The core offering is the Family Care program supplemented by Family Care Partnership and Self-Directed Supports (SDS). The organization operates primarily as a care coordination entity, connecting members to an extensive network of service modules delivered by contracted providers. The product portfolio spans 35+ service categories including residential services (Adult Family Homes, CBRFs, RCACs), in-home supports (Supportive Home Care, Remote Monitoring, Home Health), employment services (Supported Employment, Prevocational Services, VFPS), and specialized services (Mental Health, Therapy, Transportation). The technology infrastructure includes a Provider Portal for claims and billing management, Electronic Visit Verification (EVV) for service documentation, and a Learning Management System for provider training. The Commonunity® model underpins the person-centered approach to care delivery.

Differentiator

Problem solved

Functional benefit

Brands

• Commonunity: A trademarked model of support built from the belief that everyone deserves the right to control his/her life and actively participate in full citizenship.

Products and services

• Family Care program Wisconsin Family Care is a Medicaid-funded managed long-term care program for frail elders and adults with intellectual, developmental, or physical disabilities. Inclusa coordinates individualized services and supports through an interdisciplinary care team model to help members live in community settings rather than institutions.
• Family Care Partnership Family Care Partnership is a Wisconsin Medicaid managed care program option that integrates medical and long-term care services for eligible members. Inclusa participates as a Partnership MCO to deliver acute, primary, and long-term care in a coordinated package.
• Self-Directed Supports (SDS) Self-Directed Supports (SDS) is a service option that gives Family Care members and their representatives authority and budget flexibility to hire, direct, and manage their own long-term support providers rather than receiving only agency-directed services.

Named customers1 record

Segments2 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Three partnerships are on record, tiered core.

• Medical Transportation Management (MTM)coreStrategic or Co-development Partner · 1 April 2026MTM (Medical Transportation Management) is a transportation management company specializing in non-emergency medical transportation (NEMT) serving Medicaid, Medicare, government agencies, and managed care organizations for 30 years. MTM was selected by Inclusa to streamline transportation services and enhance member support. Transportation contracts will transition to MTM effective April 1, 2026, with MTM beginning service on that date to coordinate transportation for Inclusa members including website, mobile apps, and online portal access.
• Wisconsin Department of Health ServicescoreOthersInclusa operates under a contract with the Wisconsin Department of Health Services to provide Family Care, a state Medicaid-funded long-term care program. This government contract is fundamental to Inclusa's operations and member acquisition.
• Aging and Disability Resource Centers (ADRCs)coreOthersLocal ADRCs serve as key referral partners where potential members learn about Family Care program options and eligibility. Members visit local ADRCs for more information about long-term care program options, making ADRCs a critical distribution and referral channel.

Scale indicators5 records

Recent moves10 records

Expansion highlights4 records

Broad incumbents

• Centene Corporation: Largest U.S. Medicaid managed care operator with deep MLTSS exposure across multiple states; relevant comparable for capitated LTSS economics and scale-driven care coordination models.
• Elevance Health (Anthem): Major national Medicaid managed care company with Carelon services; comparable at the parent/MCO-platform level for capitated LTSS strategy and integration of Medicare/Medicaid dual-eligible members.
• UnitedHealthcare (Optum): Largest U.S. health insurer with a significant Medicaid presence and growing MLTSS footprint; provides strategic context for Inclusa's positioning within Humana's broader national LTSS ambitions.
• Molina Healthcare: National Medicaid managed care company with significant MLTSS (managed long-term services and supports) presence in multiple states; competes with Humana/iCare/Inclusa in shared-state Medicaid procurements.
• Humana Inc. Parent company of Inclusa (since 2022) and a national Medicare/Medicaid managed care leader; provides platform-level context for Inclusa's strategy but operates far beyond Wisconsin LTSS.

Direct peers

• My Choice Wisconsin: Wisconsin Family Care and IRIS managed care organization serving elders, adults with disabilities, and children with long-term care needs; direct competitor in the same Medicaid waiver programs as Inclusa.
• iCare (Independent Care Health Plan): Sister Humana subsidiary that also operates Wisconsin Family Care; iCare acquired substantially all of Inclusa's Family Care assets in June 2023, making it the closest functional peer and the integration counterpart in the Humana Wisconsin LTSS strategy.
• Lakeland Care: Wisconsin-based Family Care managed care organization serving frail elders and adults with disabilities in northeastern and north-central Wisconsin counties; overlaps with Inclusa's geographic footprint and program structure.
• Community Care, Inc. One of the original Wisconsin Family Care Managed Care Organizations serving elders and adults with disabilities across multiple Wisconsin counties; competes directly with Inclusa for ADRC referrals and DHS contracts.
• Care Wisconsin: Wisconsin Family Care and Medicare Dual Eligible Special Needs Plan MCO; competes with Inclusa in Medicaid managed long-term care across overlapping Wisconsin counties.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/inclusa-
• Xx.com/inclusaorg

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 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 Inclusa