Services

 

External Quality Review

CCME provides external quality review to ensure Medicaid recipients receive high-quality, accessible, and timely care. As a multi-state External Quality Review Organization (EQRO) we partner with state agencies and health plans to provide best practice solutions to improve system performance and patient care.

Fraud Waste and Abuse Services

Medicaid programs provide valuable services to a state's citizens - but they are unfortunately targets for financial abuse and exploitation. We evaluate the integrity of payers and providers practices to ensure citizens receive the most value from their programs.

Quality Improvement

We work closely with clients to identify gaps and risks in health care system delivery and provide the tools, strategy and operational framework necessary to take action, driving tangible results at the citizen, provider, agency and community levels.

Utilization Management

We offer expert-level review and clinical analysis of medical records and information to make determinations about the appropriateness and necessity of health care services. Our staff of licensed professionals use our proprietary technology to deliver reliable and defendable decisions to ensure that resources are used judiciously in meeting the needs of patients.

News Highlights

Eight Nonprofits Awarded Grants to Improve Health Care in the Carolinas

7/20/2021

Eight nonprofit organizations in North Carolina and South Carolina have received grants totaling $267,080 from the CCME Foundation, a nonprofit organization located in Cary, NC, supporting health care quality improvement in the Carolinas.

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CCME Foundation Launch

4/1/2021

The CCME Foundation, a nonprofit organization supporting health care improvement in the Carolinas, is accepting applications from eligible nonprofit organizations that work to improve health care for individuals and communities through measurable outcome improvement projects.

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Key Outcomes

12K+

ADMISSIONS AVERTED

Hospital admissions averted by increasing vaccinations during a five-year Provider and Practice Transformation program in South Carolina, resulting in more than $97 million in cost avoidance.

228M

TAX DOLLARS SAVED

Taxpayer dollars saved from going to fraud, waste or abuse during a 10-year Investigative Audit program with North Carolina aimed at protecting the integrity of the Medicaid program, citizens lives, providers and communities. For every $1 spent on the program, NC Medicaid saved $7.

777

DRUG EFFECTS AVOIDED

Adverse drug effects avoided by driving effective patient-centered communication during a five-year Provider and Practice Transformation program with South Carolina.

About Us

WHO WE ARE

The Carolinas Center for Medical Excellence (CCME) is an experienced health care quality consultancy, founded by physicians in 1983, to improve the quality of health care locally, regionally, and nationally. We are an independent non-profit organization.

News and Resources


Eight Nonprofits Awarded Grants to Improve Health Care in the Carolinas

News - 7/20/2021


CCME Foundation Launch

News - 4/1/2021


Stephen M. Dille, CPA, Joins CCME as Vice President of Finance & Administration

News - 2/19/2021


Vish Ganpati Joins CCME as Director of Business Development

News - 1/8/2021


North Carolina Physician Receives Outstanding Achievement Award

Awards - 10/16/2020


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