Friday, April 19, 2024

State pilots non-medical intervention program to improve healthcare for Medicaid enrollees

According to the N.C. Department of Health and Human Services, 80 percent of health outcomes are determined by social and environmental factors. A new pilot program in North Carolina is attempting to help high-need Medicaid enrollees mitigate areas of potential toxic stress and by proxy improve overall health in the state.

NCDHHS’s new Health Opportunities Pilots program tamps down the financial burden low-income households face, by covering costs in housing, transportation access, food security and interpersonal safety. It’s a systematic approach in the delivery of health care, the state explained in a release — the first of its kind in the nation to provide non-medical interventions.

North Carolina ranks in the top 10 (number eight) of food insecure states nationwide. More than one in five children live in households without consistent access to food.

Also staggering is the number of people affected by the housing crisis in the state; over a million North Carolinians are unable to secure affordable accommodations.

HOP has $650 million in state and federal Medicaid funds to be allocated in three North Carolina regions to help families achieve better stability and in turn healthier lives. The program is launching in the following counties:

  • Access East Inc.: Beaufort, Bertie, Chowan, Edgecombe, Halifax, Hertford, Martin, Northampton, Pitt
  • Community Care of the Lower Cape Fear: Bladen, Brunswick, Columbus, New Hanover, Onslow, Pender
  • Dogwood Health Trust: Avery, Buncombe, Burke, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey

In its infancy, HOP is garnering evidence to determine whether it will expand statewide. Specifically, it ascertains that investing in areas that help drive better health will in effect bring down short-term and long-term healthcare costs in communities.

The concept has been hailed by Seema Verma, former director of the Centers for Medicare and Medicaid Services (CMS), who, according to a release, wrote: “As we seek to create a health care system that truly rewards value, we must consider the impact that factors beyond medical care have in driving up health costs.”

The program works in tandem with area social service providers.

“Creating a perpetual funding stream to eliminate social detriments of health barriers could forever change the health trajectory of our most vulnerable population, as well as change the economic viability of the agencies who often struggle to support them,” a release noted.

Medicaid enrollees that reside in Bladen, Brunswick, Columbus, New Hanover, Onslow, and Pender counties are eligible upon two conditions: they have at least one qualifying physical or behavioral health condition and one qualifying social risk factor, as defined by the department.

To learn more, click here.

Tips or comments? Email

Want to read more from PCD? Subscribe now and then sign up for our morning newsletter, Wilmington Wire, and get the headlines delivered to your inbox every morning.

Shea Carver
Shea Carver
Shea Carver is the editor in chief at Port City Daily. A UNCW alumna, Shea worked in the print media business in Wilmington for 22 years before joining the PCD team in October 2020. She specializes in arts coverage — music, film, literature, theatre — the dining scene, and can often be tapped on where to go, what to do and who to see in Wilmington. When she isn’t hanging with her pup, Shadow Wolf, tending the garden or spinning vinyl, she’s attending concerts and live theater.

Related Articles