Community Care manages behavioral health services for Medical Assistance (Medicaid) members in 39 of Pennsylvania’s 67 counties, in addition to its support of behavioral health in UPMC Health Plan’s commercial and Medicare products. We also partner with CDPHP in New York to provide community-based behavioral health care management services and improve coordination of physical and behavioral health services for special populations.
We are the largest not-for-profit behavioral health managed care organization in the country with 950,000 Medicaid members, and a total enrollment of 1.6 million inclusive of UPMC Health Plan members. We hold full NCQA Medicaid Accreditation and URAC Utilization Management Accreditation. As part of UPMC Health System, Community Care is also the largest behavioral health insurance program to be owned by an academic medical center. We leverage our clinical and technological expertise and close affiliation with the University of Pittsburgh School of Health Sciences and with UPMC’s Western Psychiatric Institute and Clinic to deliver innovative behavioral health solutions that employ new models for recovery-focused health care delivery.
Community Care’s focus on recovery is unique for behavioral health managed care organizations, and thus making us a national leader in implementing recovery and wellness initiatives from a health benefits perspective. We deliver state-of-the-art care management, quality improvement, and outcomes-based program development. Our goal is to offer wellness and recovery-oriented, person-centered, accessible care that reflects contemporary best practices and recognize that improved care depends on effective partnerships with all stakeholders. We work with the most vulnerable populations including adults with serious mental illness, substance use disorders, co-occurring disorders, children at risk, and the population with behavioral health disorders and intellectual and developmental disabilities and coordinate care for individuals with the most complex needs.