Addressing social needs through Medicaid: lessons from planning and early implementation of North Carolina’s Healthy Opportunities Pilots

Addressing social needs through Medicaid: lessons from planning and early implementation of North Carolina’s Healthy Opportunities Pilots

Collection:
Health Policy and Services Research
Author(s):
Huber, Katie M., author
Bleser, William K., author
Whitaker, Rebecca G., author
Vasudeva, Karina, author
Halvorson, Jessye, author
Van Vleet, Amanda, author
Lyn, Michelle, J., author
Saunders, Robert S., (Of Duke-Margolis Center for Health Policy), author
Contributor(s):
Milbank Memorial Fund, issuing body.
Duke-Margolis Center for Health Policy, issuing body.
Publication:
New York, NY : Milbank Memorial Fund, September 2023
Language(s):
English
Format:
Text
Subject(s):
Health Planning
Medicaid
Pilot Projects
Social Determinants of Health
Social Work
North Carolina
Genre(s):
Technical Report
Abstract:
States, payers, and health systems across the United States are developing cross sectoral solutions to address health-related social needs. However, most evidence on the effectiveness of these interventions to date is from time-limited interventions focused on specific subpopulations or services and often in urban areas only. In 2019, as part of North Carolina’s Section 1115 Medicaid Demonstration, the Centers for Medicare & Medicaid Services (CMS) authorized up to $650 million in Medicaid funding to implement the Healthy Opportunities Pilots (“Pilots”). The Pilots, launched in 2021, is a cross-sectoral program providing 29 evidence-based services to address social needs related to housing, food, transportation, interpersonal violence, and toxic stress through networks of community-based organizations to eligible Medicaid enrollees in three regions of the state. The Pilots will test the impact of these interventions at scale in Medicaid for the first time, including through major new payment and delivery designs. An ongoing evaluation sponsored by CMS will examine the effect of the Pilots on health outcomes, health care utilization, and health care costs. To complement this evaluation, the authors conducted a multi-method qualitative study to generate timely and practical findings and recommendations from the planning, capacity building, and early implementation of the program. Our findings can be useful not only to the Pilots’ policymakers, implementors, and providers, but also to stakeholders interested or involved in similar or smaller-scale initiatives in other states.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (37 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918734076906676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918734076906676