CCME

What CCME does

Constellation Quality Health (legal entity behind CCME) is a Cary, North Carolina-based nonprofit healthcare quality improvement organization founded in 1983, employing 101–250 people. It specializes in external quality review (EQR), fraud/waste/abuse (FWA) prevention, behavioral health program development, outpatient specialized therapies, chronic disease management, post-acute care coordination, and workforce development, serving state Medicaid managed care organizations as its primary customer segment alongside healthcare payers, providers, and administrators across the United States.

The company's portfolio spans six core service areas plus Workforce Development, augmented by a set of solutions: the Vega technology platform, Constellation Regional Collaborative, Constellation Regional Learning Collaborative, Project ECHO (Extension for Community Healthcare Outcomes), and the Constellation Community Care Hub. Its underlying technology is a data aggregation and analytics platform that collects healthcare data from diverse markets nationwide, identifies patterns and trends relevant to specific client organizations, produces comprehensive reporting, and supports implementation of action plans. The Vega platform appears to be the productized layer through which this analytical capability is delivered, though specific technical architecture, datasets, and AI/ML components are not disclosed in available source material.

Constellation's business model is sales-led professional services with quote-based, customized engagements delivered through direct expert consulting rather than standardized product sales. Revenue derives from multi-state external quality review contracts (a federally required function for Medicaid managed care programs), bespoke quality improvement engagements, FWA audits, and participation fees for collaborative and ECHO programs. Pricing is not publicly disclosed. Marketing channels are primarily top-of-funnel content (website, LinkedIn, Facebook, RSS) supplemented by mid-funnel community engagement through Project ECHO and learning collaboratives. The organization operates without disclosed parent company, venture backing, or public listing, and ownership structure is not publicly available.

Name

CCME

Legal name

Constellation Quality Health

Website

https://thecarolinascenter.org

Company type

Private

Founded year

1983

Operating status

Operating

Headcount range

101–250 employees

Short description

Constellation Quality Health is a 1983-founded, Cary, North Carolina-based nonprofit that delivers external quality review, fraud/waste/abuse prevention, behavioral health, chronic disease, post-acute care, and workforce development services to state Medicaid managed care organizations and other healthcare payers, providers, and administrators across the United States.

Ownership category

akta.pro rank

Product category

Healthcare Quality Improvement Consulting

NAICS

Management Consulting Services (54161), Other Management Consulting Services (541618)

SIC

Services-Health Services (8000), Services-Management Consulting Services (8742)

akta.pro primary industry

Quality Measurement, Reporting & Benchmarking (HEDIS/Stars/CQM) (HLACAHAC)

akta.pro secondary industries

Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD), SNP Quality & Stars (HEDIS/CAHPS) Programs (HLAEAGAI), Provider Performance, Network Analytics & Attribution (HLACAHAF)

Keywords

• Healthcare quality improvement
• External quality review
• Fraud waste abuse prevention
• Utilization management services
• Medicaid managed care consulting

Headquarters

HQ city

Cary

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, Others

Revenue model

1. Healthcare Quality Consulting Services: Professional consulting services providing expert analysis, recommendations, and implementation support for healthcare quality improvement, external quality review, fraud waste and abuse prevention, and related healthcare management needs.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels4 records

Core offering

Constellation Quality Health provides healthcare quality improvement consulting and advisory services, including external quality review, fraud/waste/abuse detection, behavioral health program support, outpatient specialized therapy quality improvement, chronic disease management, post-acute care coordination, and workforce development. The firm leverages a national data aggregation and analytics platform to deliver pattern identification, reporting, and implementation support to healthcare organizations.

Product overview

Constellation Quality Health is a health care quality improvement and consulting organization offering a platform of solutions and professional services. The portfolio includes technology platforms (Vega), collaborative programs (Constellation Regional Collaborative, Constellation Regional Learning Collaborative, Project ECHO), a community coordination hub (Constellation Community Care Hub), and six core service areas covering External Quality Review, Fraud/Waste/Abuse prevention, Outpatient Specialized Therapies, Behavioral Health, Chronic Disease management, and Post-Acute Care. The company also provides workforce development support and leverages data aggregation and analysis capabilities to deliver reporting and implementation guidance for health care organizations.

Differentiator

Problem solved

Functional benefit

Brands

• Vega: A solution/product mentioned in the Solutions section of the website
• Constellation Regional Collaborative
• Constellation Regional Learning Collaborative
• Project ECHO
• Constellation Community Care Hub

Products and services

• Vega A technology platform solution offered as part of Constellation's portfolio of health care quality improvement tools.
• Constellation Regional Collaborative A collaborative initiative bringing together regional partners to address health care quality and system performance improvement.
• Constellation Regional Learning Collaborative A learning collaborative focused on education and knowledge sharing among regional health care stakeholders.
• Project ECHO Extension for Community Healthcare Outcomes program providing peer-to-peer learning and specialist consultation for health care providers.
• Constellation Community Care Hub A centralized hub connecting health care organizations with resources and coordination services for improved patient outcomes.
• External Quality Review Expert analysis and review services to ensure quality standards in health care delivery and compliance with regulatory requirements.
• Fraud, Waste, and Abuse Detection and prevention services to protect health care organizations from financial waste and fraudulent activities.
• Outpatient Specialized Therapies Quality improvement support for specialized therapeutic services delivered in outpatient settings.
• Behavioral Health Expertise and support services focused on improving quality and delivery of behavioral health care programs.
• Chronic Disease Quality improvement programs targeting chronic disease management and prevention strategies.
• Post-Acute Care Quality improvement and coordination services for care delivered after acute hospital episodes.
• Workforce Development Programs and resources to develop and strengthen health care workforce capabilities and competencies.

Named customers2 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Recent moves5 records

Expansion highlights4 records

Direct peers

• Health Services Advisory Group (HSAG): One of the largest External Quality Review Organizations (EQROs) in the U.S., serving state Medicaid agencies and MCOs with quality review, HEDIS/CAHPS, and quality improvement services — directly comparable to CCME's core EQR offering.
• MetaStar: Independent, non-profit quality improvement organization providing EQR and quality improvement consulting to Wisconsin and other state Medicaid programs, comparable in mission and service mix to CCME.
• Telligen: Quality improvement organization providing healthcare quality review, population health, and federal/state program support to Medicaid and public health clients — directly comparable to CCME's QI and EQR work.
• Qsource: Non-profit quality improvement organization offering EQR, quality measurement, and improvement services to Medicaid programs and providers, closely mirroring CCME's structure and customer mix.
• TMF Health Quality Institute: Non-profit quality improvement organization serving state Medicaid agencies with EQR, HEDIS, and quality improvement services across multiple states — directly comparable non-profit peer.
• IPRO: Independent EQRO providing external quality review, utilization management, and quality improvement services to state Medicaid and Medicare programs, operating across multiple states in a manner comparable to CCME.
• Comagine Health (formerly Qualis Health): Non-profit quality improvement and consulting organization serving Medicaid, Medicare, and provider clients with EQR, population health, and care transformation services — directly comparable to CCME.
• Acentra Health (formerly Kepro): Healthcare quality and care management services company serving state Medicaid agencies and MCOs with utilization management, quality review, and program integrity services — directly competitive in CCME's core segments.

Broad incumbents

• Change Healthcare (now Optum): Large-scale healthcare technology and analytics company offering quality, payment integrity, and risk adjustment solutions across payers and providers, intersecting with CCME's analytics and quality measurement work.
• Cotiviti: Large healthcare analytics and payment integrity company offering quality measurement, HEDIS/Stars, and population health analytics; overlaps with CCME's quality measurement and FWA services but operates at much greater scale and broader scope.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/MyCCME
• LinkedInlinkedin.com/company/constellation-quality-health
• Xx.com/MyCCME

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 CCME