Program Overview



Community Care of North Carolina (CCNC) is a state-wide, provider-led primary care medical home and care coordination population health infrastructure that has been growing since 1998. It is a private-public partnership with 14 networks covering all 100 NC counties. CCNC activities improve access to, quality, coordination, and cost-effectiveness of care for Medicaid, Health Choice, select Medicare and privately insured populations. Statewide more than 5000 primary care providers and approximately 1.4 million Medicaid enrollees are part of the CCNC infrastructure.


Community Care of Wake and Johnston Counties (CCWJC) was established in 2003 and is one of the 14 local networks. Currently, there are 160 primary care medical homes and 125,000 patients in Wake and Johnston counties as part of the CCWJC network. CCWJC works closely with these local primary care medical homes, their patients and community partners.  CCWJC:


  • Provides data and analytics to guide population health activities
  • Promotes best practice management for chronic diseases and quality improvement initiatives
  • Provides multi-disciplinary care management, including transitional care, for high risk patients that includes nurses, social workers, pharmacists, physicians, a dietician, and a chaplain
  • Supports pharmacy initiatives to maximize patient safety, medication adherence, and cost-effective medication management
  • Fosters integrated behavioral and physical health care and holistic care for special populations
  • Links major segments of the local health care systems (hospitals, public health, primary care providers, pharmacies, specialists, behavioral health providers, social services, community resources, etc.)
  • Works to address underlying social determinants of health