Community Care of the Lower Cape Fear

What Community Care of the Lower Cape Fear does

Community Care of the Lower Cape Fear (CCLCF) is a 501(c)(3) nonprofit organization founded in 2003 and headquartered in Wilmington, North Carolina. It delivers care management and care coordination services across a six-county region in southeastern North Carolina (Bladen, Brunswick, Columbus, New Hanover, Onslow, and Pender), serving Medicaid Managed Care beneficiaries, Medicare patients with multiple chronic conditions, uninsured and under-insured residents, pregnant women and infants, and other high-need populations. CCLCF is NCQA-accredited for Complex Care Management (perfect score of 100 in 2018) and is one of only three Network Leads for the North Carolina Healthy Opportunities Pilot (HOP), the nation's first comprehensive Medicaid program funding non-medical interventions for food, housing, transportation, and interpersonal safety.

CCLCF's core offerings are Medicaid Care Management, Care Management for Seniors (Chronic Care Management, Transitional Care Management, Annual Wellness Visits), and the Healthy Opportunities Pilot network lead role. These are supported by modular services including the CDC Diabetes Prevention Program, Healthcare Navigation through the Help Hub at the Harrelson Center, Pharmacy Services (clinical pharmacist practitioners, medication reviews), the Perinatal Nurse Champion program, and the integrated Pathway to Wellness bundle. The underlying technology stack is intentionally narrow and focused on care coordination rather than analytics: integration with the statewide NCCARE360 referral network for closed-loop resource referrals and DocsInk for telehealth, secure provider communication, and video visits. No proprietary AI or machine-learning capabilities are described.

Revenue is generated through a multi-payer mix rather than direct consumer fees: delegated care management contracts with Prepaid Health Plans (notably Carolina Complete Health), Medicare CCM/TCM/AWV billing across a network of 550+ primary care providers, ACO and provider practice contracts, and a growing base of foundation and corporate grants (New Hanover Community Endowment $1.5M, Kate B. Reynolds Charitable Trust, Blue Cross Blue Shield of North Carolina Foundation, Live Oak Bank). The organization partners with 50+ human service organizations, 7 hospitals, multiple county health departments, and an LME/MCO (Trillium Health Resources), distributing services through enterprise contracts and direct community navigation rather than a traditional sales motion.

Name

Community Care of the Lower Cape Fear

Legal name

Community Care of the Lower Cape Fear

Website

https://carelcf.org

Company type

Private

Founded year

2003

Operating status

Operating

Headcount range

101–250 employees

Short description

Community Care of the Lower Cape Fear is a 501(c)(3) nonprofit founded in 2003 that delivers NCQA-accredited care management, Medicare chronic care services, and the Healthy Opportunities Pilot across six southeastern North Carolina counties for Medicaid, Medicare, and uninsured populations.

Ownership category

akta.pro rank

Headquarters

HQ city

Wilmington

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Medicaid Care Management Contracts: CCLCF was selected by NC Medicaid program to manage enrollees' medical, social, and behavioral conditions. Revenue generated through contracted care management services with Prepaid Health Plans (PHPs) for Medicaid Managed Care beneficiaries.
2. Medicare Care Management: Care management programs for Medicare patients dealing with two or more chronic conditions, including Chronic Care Management, Transitional Care Management, and Annual Wellness Visits.
3. Foundation Grants: Strategic planning grants and program funding from foundations including New Hanover Community Endowment ($1.5 million), Kate B. Reynolds Charitable Trust, Blue Cross Blue Shield of North Carolina Foundation.
4. Healthy Opportunities Pilot (HOP): As one of three Network Leads for HOP, CCLCF coordinates social determinants of health services (food, housing, transportation, interpersonal safety) for Medicaid Managed Care enrollees. Network HSOs deliver 29 non-medical, evidence-based interventions.

Go-to-market motion3 records

Distribution channels4 records

Marketing channels6 records

Core offering

CCLCF delivers coordinated care management services for Medicaid beneficiaries and Medicare patients across six Southeastern North Carolina counties, including complex care management, chronic care management, transitional care management, and annual wellness visits. As one of three Network Leads for the North Carolina Healthy Opportunities Pilot, it also coordinates non-medical interventions (food, housing, transportation, interpersonal safety) for Medicaid Managed Care enrollees. Services are contracted through Prepaid Health Plans, ACOs, primary care providers, hospitals, and government programs, supported by pharmacy, healthcare navigation, and diabetes prevention programs.

Product overview

Community Care of the Lower Cape Fear (CCLCF) is a 501(c)(3) nonprofit organization offering a coordinated care management platform focused on whole-person health. The core offerings include Medicaid Care Management, Care Management for Seniors, and the Healthy Opportunities Pilot (HOP) as one of three Network Leads. These are supported by modular services including the CDC Diabetes Prevention Program, Healthcare Navigation (Help Hub), Pharmacy Services, Perinatal Nurse Champion program, and Pathway to Wellness. CCLCF also operates the Cape Fear HOP Social Care Network connecting medical, behavioral, and social services across six Southeastern NC counties.

Differentiator

Problem solved

Functional benefit

Products and services

• Medicaid Care Management Care coordination and complex care management services for Medicaid beneficiaries in the NC Medicaid Managed Care model, supporting patients and providers through a whole-person centered approach.
• Care Management for Seniors Comprehensive care management services for Medicare patients with two or more chronic conditions, including Chronic Care Management, Transitional Care Management, and Annual Wellness Visits.
• Healthy Opportunities Pilot (HOP) Nation's first comprehensive program testing non-medical interventions related to food, housing, transportation, and interpersonal safety/toxic stress for Medicaid Managed Care enrollees; CCLCF serves as Network Lead for the Cape Fear region.
• CDC Diabetes Prevention Program (DPP) CDC-recognized lifestyle change program to prevent or delay type 2 diabetes through healthy eating and physical activity, delivered by trained lifestyle coaches with year-long support.
• Healthcare Navigation Health navigation services through the Help Hub providing assistance with Medicaid applications, specialist referrals, medication assistance, and connection to community resources for food, housing, and employment for insured, uninsured, and under-insured individuals.
• Pharmacy Services Clinical pharmacy services including curbside consults, population drug monitoring, comprehensive medication reviews, and collaborative practice partnerships with medical practices.
• Perinatal Nurse Champion Grant Maternal health innovation program providing best-practice education and resources to reduce disparities in maternal morbidity and mortality, serving Region V of North Carolina's Perinatal Regions.
• Pathway to Wellness Integrated services combining Chronic Care Management, Diabetes Prevention, Pharmacy Services, and Healthcare Navigation to support community and family members as a single coordinated program.
• Social Care Network Coordinated care network connecting health and social support providers, developed with local Human Service organizations building on the Healthy Opportunities Pilot model.

Quantifiable outcome

• 33% reduction in inpatient admissions
• +9 more outcomes

Named customers6 records

Segments7 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature2 records

Partnerships

14 partnerships are on record, tiered core, major and minor.

• NC Department of Health and Human ServicescoreStrategic or Co-development PartnerCCLCF provides care management, care navigation and Social Determinant of Health Support to Medicaid beneficiaries. Also serves as one of three Network Leads for the Healthy Opportunities Pilot program.
• Carolina Complete HealthcoreStrategic or Co-development PartnerOne of North Carolina Medicaid's Prepaid Health Plans and the only provider-led entity. CCLCF provides delegated complex care management, LTSS care management, care coordination, and HOP care management for CCH members.
• Trillium Health ResourcescoreStrategic or Co-development PartnerLME/MCO partner. Awarded 2017 Transforming Lives Award for Care Integration. Partnered on Pediatric Pilot for patients with Intellectual and Developmental Delays. Recipient of 2026 i2i Quality Innovations Award.
• Cape Fear HealthNetmajorStrategic or Co-development PartnerLocal 501c3 creating a coordinated system of healthcare for the poor and uninsured. Collaborative work focuses on helping uninsured navigate healthcare system, particularly with Specialists.
• Cape Fear CollectivemajorStrategic or Co-development PartnerValued partner supporting the Healthy Opportunities Pilot and The Harrelson Center Help Hub initiative using data science to drive change.
• Harrelson CentermajorStrategic or Co-development PartnerCCLCF operates Help Hub Care Navigation through a two-year grant from Live Oak Bank. Help Hub provides health care navigation and resources for community members.
• DocsInkmajorTechnology or IntegrationLocal telehealth option integrated into care management and coordination. Provides essential space for care teams to share data, communicate securely with providers, and video chat with patients.
• Access East (ECU Health Affiliate)majorStrategic or Co-development PartnerCCLCF provides care coordination, complex care management, and provider support services to local contracted primary care providers in the six-county region.
• Mt. Calvary Center for Leadership DevelopmentminorStrategic or Co-development PartnerCCLCF announced membership to Mt. Calvary Executive Leadership Society. Organization serves mostly low income and rural communities including under-served minority communities.
• New Hanover Resiliency Task ForceminorStrategic or Co-development PartnerOne of 55 organizations in New Hanover County committed to building a resilient and compassionate community through trauma-informed approaches.
• Novant HealthmajorStrategic or Co-development PartnerRegional partnership through Novant Health Brunswick Medical Center (Regional Manager on Board) and Chief Nursing Officer involvement.
• South East Area Health Education CentermajorStrategic or Co-development PartnerPresident & CEO Joseph Pino serves as Board Chair for CCLCF. SEAHEC VP GME of New Hanover Regional Medical Center.
• NCCARE360majorTechnology or IntegrationFirst statewide coordinated care network to electronically connect those with identified needs to community resources and allow for a feedback loop on the outcome of that connection.
• NC MedicaidcoreStrategic or Co-development PartnerSelected by NC Medicaid program to manage enrollees' medical, social, and behavioral conditions. One of three Network Leads for the Healthy Opportunities Pilot.

Scale indicators17 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Community Care of North Carolina: The umbrella network of regional Community Care affiliates; CCLCF operates as a local affiliate in the CCNC system, sharing the same care management model, payer relationships, and statewide infrastructure.
• Access East: ECU Health-affiliated care management organization providing complex care management and provider support in eastern North Carolina; directly comparable as a regional Network Lead-style entity.
• Community Care of the Sandhills: Regional Community Care network serving the Sandhills region of NC; offers Medicaid and Medicare care management services and is part of the same CCNC-affiliated network as CCLCF.
• Community Care of Western North Carolina: Sibling Community Care network serving western NC; provides the same NC Medicaid care management and HOP-adjacent services under the CCNC model.

Broad incumbents

• Trillium Health Resources: NC LME/MCO managing behavioral health and intellectual/developmental disability services; CCLCF partners with Trillium on HOP and has received joint innovation awards, making it a strategic peer in the same managed-care ecosystem.
• Vaya Health: Another NC LME/MCO with overlapping managed-care responsibilities and Tailored Plan operations; comparable as a regional behavioral health and care coordination payor/provider.
• Carolina Complete Health: NC Medicaid Prepaid Health Plan (provider-led) that delegates complex care management, LTSS, and HOP services to CCLCF; comparable as a Medicaid managed care organization operating in the same market.

Regional players

• Well Care Home Health: North Carolina home health and care management operator (former employer of CCLCF's CFO); comparable in regional scale and Medicare care management focus, though not a direct competitor.

Emerging players

• Unite Us: National technology platform for social determinants of health referral networks (NCCARE360's national parent); comparable in addressing SDoH coordination, though technology-led rather than care-management-led.
• findhelp (formerly Aunt Bertha): Social care referral platform serving health plans, providers, and community organizations; comparable to CCLCF's NCCARE360 integration and SDoH navigation mission, with broader national reach.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/community-care-of-the-lower-cape-fear
• Facebookfacebook.com/communitycarelcf

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 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 Community Care of the Lower Cape Fear