Community Care of the Sandhills (CCS) is a non-profit organization that was formed as a 501 c3 in May 2003 to provide care management services to the Carolina Access Medicaid recipients in Harnett, Hoke, Lee, Montgomery, Moore, Richmond, and Scotland counties. Medicaid is a federal-state health insurance program for children, low-income parents, older adults, and people with disabilities. Many patients have several ongoing conditions, such as heart disease and diabetes, and face social and economic hurdles that complicate their health. In 1998, North Carolina launched the Community Care of North Carolina (CCNC) program for its Medicaid beneficiaries. Adopting an enhanced medical home approach, CCNC piloted many of the ideals referenced in national health reform efforts being discussed today to address the challenges of maintaining quality while controlling costs. The program is looked at as a successful model for population-based health management. All 100 North Carolina counties are served by 14 networks. Together, these networks manage over one million North Carolina Medicaid enrollees collaborating with 4,000 primary care physicians in 1,877 practices. Community Care of the Sandhills is one of 14 networks participating in CCNC. With the goal of enhancing health care quality, increasing efficiency, improving patient safety and lowering costs, CCS is a local network serving more than 74,000 North Carolina Medicaid enrollees in a rural seven-county area.