Eight-Clinic Primary Care Group Leverages North Carolina's Health Information Exchange to Drive Down Medicare and Medicaid Costs

Generations Family Practice posts 2025 Medicare costs about 38% below the statewide average and Medicaid loss ratios roughly 10% below state averages.

CARY, N.C., July 29, 2026 /PRNewswire-PRWeb/ -- Cary Medical Management (CMM), a management services organization (MSO), today reported that the primary care group it manages, Generations Family Practice (GFP), achieved significant reductions in medical costs for Medicare and Medicaid patients in 2025 by deploying proprietary technology that integrates with North Carolina's statewide health information exchange (HIE), NC HealthConnex. The results, drawn from independent Medicare and Medicaid data, point to a measurable return on the state's investment in NC HealthConnex.

GFP operates eight clinic locations across North Carolina and serves approximately 24,000 value-based care (VBC) contracted lives. CMM uses the clinics to deploy and refine proprietary technology developed with its sister companies, Smartlink Health and Infina Connect, in collaboration with the MSO and clinic staff. The technology leverages state HIE data to reduce the total cost of care for both commercially insured and government-funded patients. This approach previously produced a documented 32% cost reduction for commercially insured patients who moved from other local practices to CMM-managed clinics, as measured by a local clinically integrated network (CIN). New 2025 Medicare and Medicaid data show similar gains for government-funded patients.

MEDICARE: 38% BELOW THE STATEWIDE AVERAGE

For the 1,291 patients attributed to GFP under the Medicare Shared Savings Program (MSSP), average annual medical cost fell to $9,649 per beneficiary in 2025 — as reported by an accountable care organization (ACO) that analyzed Centers for Medicare & Medicaid Services (CMS) data. That figure is $6,021, or roughly 38%, below the most recent available 2024 North Carolina statewide average of $15,670, and well under the Triangle-region average of about $11,400 — a region likely already benefiting from NC HealthConnex.

MEDICAID: LOSS RATIOS ~10% BELOW STATE AVERAGES

Two of North Carolina's four Medicaid Managed Care payers reported GFP's recent results. One reported a medical loss ratio (MLR) — the share of premium dollars spent on medical care, where a lower figure signals more efficient, lower-cost care — of 84.3% for 3,011 members, about 11% below that payer's statewide average, which sits in the mid-90s. A second reported an MLR of 82.2% for 2,569 members (as of February 2026), about 10% below its statewide average. For context, North Carolina Medicaid spends more than $35 billion to cover 3.1 million lives; this translates to roughly $1,000 in savings per member per year.

HOW THE RESULTS WERE ACHIEVED

Rather than relying on traditional care management, which typically reaches only a small share of patients, CMM applied three proprietary technologies across its entire VBC population in 2025 — each drawing on data from NC HealthConnex:

• CMM's DxInsight, for diagnosis discovery — which sources diagnosis and other clinical data primarily from the NC HealthConnex clinical portal, in addition to ACO and CIN portals.
• Smartlink Health's Transitional Care Management (TCM) platform, to reduce hospital readmissions — which pulls hospital discharge information every two hours from NC*Notify, NC HealthConnex's Admission, Discharge, and Transfer (ADT) alert service.
• Infina Connect's Intelligent Care Coordinator, for care coordination and referrals — which passes diagnosis and discharge information to specialists who adopt Infina's electronic data transfer, giving both primary care and specialists a full view of each patient's medical conditions.

"We are driving to be the best-in-class value-based-care provider in the country. The NC HealthConnex technology is a critical element of our strategy, and we could not have achieved these results without it. We anticipate our 2026 VBC payment will exceed 20% of our encounter revenue as a result of this technology and our clinical team's dedication to adopting it." — Anshita Chaturvedi, M.D., M.P.H., Director of Quality, Cary Medical Management

NC HealthConnex is operated by the North Carolina Health Information Exchange Authority, which administers the state's HIE on behalf of the North Carolina Department of Information Technology.

"North Carolina built NC HealthConnex so that clinicians across the state could see a more complete picture of each patient's care. Results like these show what becomes possible when providers put that shared information to work — stronger outcomes for patients and lower costs for the taxpayers and employers who fund their care. Generations Family Practice is a compelling example of the value the exchange was created to deliver." — Sam Thompson, Executive Director, North Carolina Health Information Exchange Authority

ABOUT CARY MEDICAL MANAGEMENT

Cary Medical Management (CMM) is a management services organization that manages and operates Generations Family Practice and its primary care clinics across North Carolina. CMM combines MSO operational discipline with direct access to proprietary referral-management, EHR-integration, value-based care, and Medicare-program technology, deploying these tools across its managed clinics to improve patient outcomes and lower the total cost of care.

ABOUT GENERATIONS FAMILY PRACTICE

Generations Family Practice (GFP) is a tech-enabled primary care group operating eight locations across seven North Carolina cities, with 28 providers and more than 90,000 patient visits annually. GFP has been recognized as a #1 Healthcare Innovator (2024) and a Gartner® Eye on Innovation finalist (2024) for its use of proprietary technology and health-information-exchange data to deliver measurably better outcomes at lower cost.

Media Contact

April Koontz, Cary Medical Management, 1 9196748411, april.koontz@carymso.com, www.carymso.com

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SOURCE Cary Medical Management