ASHEVILLE, NC – July marks one year since Vaya Health launched its NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan—called Vaya Total Care, designed to provide whole-person care to individuals with complex needs across 32 counties in North Carolina. The Vaya Total Care plan is designed to provide coordinated services for individuals with serious mental illness, substance use disorders, intellectual/ developmental disabilities (I/DD), and traumatic brain injuries (TBI), uniting physical health, vision care, behavioral health, pharmacy, long-term services and supports, and social supports into one comprehensive care solution.
Members getting the care they need is the cornerstone of Vaya Total Care. Over the past year, the plan has improved access to and coordination of care for over 42,800 members through its integrated Tailored Plan model.
“Vaya’s history of serving North Carolinians with complex needs goes back more than 50 years,” said Tracy Hayes, Area Director and CEO of Vaya. “Early on, we recognized the positive impact of comprehensive, community-based care and developed a robust network of providers to help members meet their health goals. The success we’ve seen in the first year of Vaya Total Care reaffirms our focus on integrated care managed by organizations with deep roots in the health of the communities we serve. We will continue to invest in our providers and our communities so that together we can meet the needs of members with complex health challenges.”
Whatever their health needs, members of Vaya Total Care as well as Vaya’s Medicaid Direct plan have access to a convenient network of providers throughout the state. Vaya’s combined network adequacy score across all 100 North Carolina counties stands at 94.4% for physical and behavioral health. Vaya’s robust provider network includes more than 20,000 behavioral health providers, 38,000 physical health providers, 2,100 pharmacies, and 100 health departments and federally qualified health centers.
Vaya has also demonstrated strong operational performance, paying over $706 million for more than 2.8 million total claims through April 30, 2025. On average, medical and pharmacy claims were processed within 10 days, ensuring timely support for providers and members.
Molly’s* Story: Asthma, Anxiety, and Integrated Care
Molly’s journey highlights the life-changing impact of whole-person care in action. A woman in her early 40s, Molly has moderate intellectual/developmental disabilities, generalized anxiety disorder, major depressive disorder, chronic pain, and asthma. Her prescriptions included a Symbicort daily-use inhaler and a Ventolin inhaler for use as needed.
A Vaya clinical pharmacist became concerned when reviewing Molly’s health information, noting no recent fills of Symbicort. As a maintenance medication, Symbicort should be taken regularly—not doing so often leads to overuse of a Ventolin rescue inhaler and worsens the physical symptoms of generalized anxiety disorder.
Thanks to this cross-check by the pharmacist, a registered nurse reached out to Molly and her family to explore ways to bolster her daily use of Symbicort, seeking to improve her behavioral and physical health based on a pharmacy review.
“Prior to Vaya Total Care launching, getting access to a member’s full prescription chart and refill history would have been challenging,” said Dr. Heather Cree, Vice President of Pharmacy Operations at Vaya. “For the past year, the combination of behavioral health, physical health, and pharmacy — all covered by one health plan — has helped support the health of those in the 32 counties we serve.”
*“Molly” is a pseudonym
To learn more about Vaya Total Care and the services available, visit www.vayahealth.com/health-plans/vaya-total-care/ or call the Member and Recipient Service Line at 1-800-962-9003, available 7 a.m. – 6 p.m., Monday through Saturday.
About Vaya Health
Vaya Health is a specialty managed care organization and local government agency that oversees publicly funded health care services across a 32-county region of North Carolina for people with significant behavioral health needs, intellectual/developmental disabilities, and traumatic brain injuries. Vaya manages Medicaid, federal, state, and local funding to meet member and community needs while advancing whole-person health. Together with members, contracted providers, and local partners, we’re moving forward to a healthier North Carolina. Vaya Health can be found online at vayahealth.com, on Facebook at facebook.com/VayaHealth/, on X (formerly known as Twitter) @VayaHealth, and on LinkedIn at linkedin.com/company/vaya-health.
