Latest news with #HealthyOpportunitiesPilot
Yahoo
18-03-2025
- Health
- Yahoo
NC health program praised as administrators seek legislators' help to expand
Map of NC counties participating in the Healthy Opportunities Pilot. (Source: NC DHHS) North Carolina launched a program called Healthy Opportunities in 2022 in three mostly-rural regions of the state to see if providing food, transportation, housing, and other non-medical health-related needs for people who use Medicaid as their insurance would improve their physical health. The federal government, which approved the Healthy Opportunities Pilot during President Donald Trump's first administration, has given the state the green light to expand statewide. 'Too often non-medical factors like lack of access to healthy foods or inability to get to an in-person appointment seem to stand in the way of disease prevention and better primary care,' said Dr. Mark McClellan, director of the Duke-Margolis Institute for Health Policy. 'This pilot has aimed to develop the infrastructure needed to enable these kinds of non-medical factors to be addressed, when they can help lower overall costs and improve health.' The state Department of Health and Human Services is hoping the legislature will support Healthy Opportunities' expansion. With budget season underway, Duke-Margolis hosted a video roundtable on the Health Opportunities Pilot where participants extolled the program not only for improving health, but for helping people recover from Helene, supporting small and medium-sized farms, and helping to reduce health care provider burnout. 'The question is, because of all the success we have had, how can North Carolina not afford to scale statewide?' said former DHHS secretary Kody Kinsley. 'We've got to continue to push forward because we need to control costs of health care broadly and upstream prevention is the clear answer,' he said. 'It's the win-win in driving down costs and improving health.' The Centers for Medicare & Medicaid Services (CMS), the federal office that oversees Medicaid, published an interim evaluation of Healthy Opportunities in November 2024. It said 11,809 people received the program's services between March 2022 and November 2023. Dr. Seth Berkowitz, an associate professor at the UNC School of Medicine, is leading the formal CMS evaluation. 'We found that the program reduces health-related social needs, so we see less food insecurity, less housing instability, things like that, when people participate in the program,' he said. The analysis reported a decline in emergency room visits that may be attributable to Healthy Opportunities. It estimated a statistically significant reduction in hospital admissions for adults. However, the estimated reductions in hospital admissions for pregnant individuals, and children and teenagers were not statistically significant. Hospital admissions for children three years old and younger were estimated to have increased. Considering health care costs in the 12 months before and the 12 months after enrollment in Healthy Opportunities, health care savings attributable to the program were $85 per person per month, according to the evaluation. The savings are coming from better health, not denying services, Berkowitz said. 'People still have access to all the same health care they've had before,' he said. 'A change in spending is really a strong indicator that people's health is improving and that is why we're seeing the need for health care spending go down.'
Associated Press
10-02-2025
- Health
- Associated Press
Unite Us to Be Featured on Viewpoint with Dennis Quaid
Unite Us, the nation's leading technology partner for social care transformation, will be featured in an upcoming segment on Viewpoint with Dennis Quaid. The documentary will spotlight Unite Us' decade-long partnership with North Carolina and the recent success of its ground-breaking Medicaid waiver program, Healthy Opportunities Pilots (HOP) which has set a national standard for addressing and reimbursing for non-medical services such as food, transportation, and housing. For nearly a decade, Unite Us has served as the technology backbone for North Carolina's Medicaid transformation efforts, providing the infrastructure to streamline referrals, service authorizations, and reimbursements for non-medical services through NCCARE360, the statewide network connecting individuals to care, powered by Unite Us infrastructure. The Healthy Opportunities Pilot (HOP), is a five-year, $650 million effort, focused on delivering and paying for critical interventions such as housing, food security, transportation, and interpersonal safety for high-need Medicaid members. As the nation's first comprehensive program to assess the impact of targeted, evidence-based non-medical interventions—covering housing, food, transportation, interpersonal safety, and toxic stress—on high-needs Medicaid enrollees, HOP has improved individuals' outcomes while demonstrating the financial sustainability of integrating social care into healthcare. When to Watch National Commercial: Airs February 12, 2025, on Fox Business Network during primetime. Regional Commercial: Four broadcasts in the Top 100 U.S. markets throughout February 2025. Public Television Segment: Distributed to 170+ stations nationwide starting February 10, 2025, with airings continuing through 2026. North Carolina's HOP: Transforming Lives and Delivering Results The Healthy Opportunities Pilot is achieving measurable success: $85 Medicaid savings per participant per month 29,202: Medicaid enrollees served. 96%: Invoices accepted, paid, or in progress. $152M: Amount paid for services delivered. *Data through Dec. 31, 2024 The documentary features the transformational impact of the DHHS' initiative to address social drivers of health for North Carolinians by enabling seamless collaboration between government, healthcare, and community-based organizations to improve health outcomes and reduce costs. 'At the end of the day, people need access to basic essentials like food, housing, and transportation, no matter where they live,' said Taylor Justice, co-founder and president of Unite Us. 'North Carolina sets the gold standard for tackling these challenges. Unite Us provides the technology and infrastructure to address basic needs and drive initiatives that genuinely improve lives.' By sharing success stories like those in North Carolina, Unite Us demonstrates how technology can streamline service delivery, build capacity, proven to reduce costs, and create lasting impact across communities. North Carolina's success has provided inspiration for other states to set their sights on ambitious Medicaid waiver initiatives, such as Oregon, New York, and Missouri with a shared goal to make these lasting benefits in Medicaid. Unite Us' technology enables these states to build unified ecosystems, deliver actionable data insights, and scale sustainable referrals and payment solutions. To learn more, visit Unite Us is the nation's premier technology provider for transforming social care. Our advanced product suite is used to proactively coordinate services using data-driven insights, streamline referral and case management, and facilitate eligibility assessments and reimbursements across government, healthcare, health plans, and community organizations. The first of its kind, our closed-loop referral system prioritizes privacy and dignity and has integrated data and analytics tools used to measure impact, optimize programs, and shape policy. With over 1.5M services, we host the nation's largest network of community-based health and social services dedicated to improving whole-person health. Learn more at and LinkedIn. SOURCE: Unite Us Copyright Business Wire 2025. PUB: 02/10/2025 02:38 PM/DISC: 02/10/2025 02:38 PM
USA Today
10-02-2025
- Health
- USA Today
Successful rural county health program could go statewide — if politics don't get in way
Successful rural county health program could go statewide — if politics don't get in way Show Caption Hide Caption After losing her home to Helene, North Carolina woman sees community unite Valerie White lost her home to Tropical Storm Helene, and has been living in a donated trailer. She reflects on how the community has united since the storm. Successful rural county health program could go statewide—if politics don't get in the way In 2022, North Carolina launched an experimental initiative to address the nonmedical health needs of low-income residents by using Medicaid dollars. This first-in-the-nation effort, known as the Healthy Opportunities Pilot, has provided assistance to nearly 30,000 people across three largely rural regions of the state. Beneficiaries get deliveries of food, rides to doctor's appointments and other services that are designed to combat the various social, economic and geographic issues that contribute to health disparities. Only 33 of the state's 100 counties are included in the pilot, but more communities could be covered if lawmakers vote to expand it. The $650 million pilot was created through a waiver, issued by the Centers for Medicare and Medicaid Services, that allowed the N.C. Department of Health and Human Services to use federal Medicaid funds — usually earmarked for medical expenses — to address needs like food, transportation and housing. During the final weeks of the Biden administration, CMS approved a waiver extension that gives the department the option of taking the program statewide. Kody Kinsley, the former NCDHHS secretary who spearheaded the program's rollout, said expanding the initiative will require the blessing of the N.C. General Assembly, which must agree to match whatever funding is ultimately provided by the federal government. Still, he believes the results will justify the investment. Early research shows the state is spending about $85 less in medical costs per month for each person participating in the pilot. Participation in the program has also been 'associated with decreased emergency department utilization,' according to a report from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. 'This is something worth doubling down on,' Kinsley said in a recent interview with NC Health News. 'It's a huge investment for the federal government, but it's also a huge affirmation that our strategy is working.' While the waiver extension allows the pilot to continue through 2029, the new administration in Washington has Medicaid cuts in its sights — making the program's future far from secure. Boosting small businesses Three agencies facilitate services for program participants in the pilot regions. These organizations — Access East, Community Care of the Lower Cape Fear and Impact Health — act as intermediaries, coordinating the distribution of goods and services through a network of more than 140 nonprofits and community partners. Laurie Stradley, executive director of Impact Health, said the Healthy Opportunity Pilot is unique in that it was offered in rural areas of the state first, which is 'not always the norm for pilot programs.' Her agency is the largest of the three network leads, covering 18 counties across the mountainous Western North Carolina. She said the pilot has had a 'ripple effect' on the region's economy. For example, the food participants receive through the program is often purchased from local growers. 'We've heard from some of our produce providers and some of the farms themselves that Healthy Opportunities allows them to make plans and have a market to sell their fresh local produce in a way that is more consistent than some of their other marketplaces,' she said. 'They know that they're going to get a consistent order from the nonprofits we work with.' That weekly box of food has a ripple effect in the local economy in other ways. 'We had one mother say, 'You know, because I know that food box is coming on Friday, I feel safe paying my rent on Wednesday,'' Stradley said. 'Because she knows her family is going to eat, she can safely make that investment, which instantly improves her health stability and prevents her from getting behind in rent.' Families in the program can also then redirect their dollars to paying utilities. Utility shutoffs are a common cause of people being evicted from their apartments, Stradley explained. 'If you know the power gets turned off, landlords are not often going to allow folks to stay in that space,' she said. 'So when we can help people get up to date on their utilities, then they're also more likely to be able to stay housed.' But there's got to be somewhere for people to live in the first place, which was difficult in western North Carolina even before the remnants of Hurricane Helene ravaged the housing stock. A lifeline after disaster Participation in the Healthy Opportunities Program grew in the aftermath of Helene, which displaced many families in the region. 'The folks that were already receiving some degree of services are finding that they have more needs,' Stradley said. 'Then we also have folks who are newly eligible for Medicaid and the Healthy Opportunities Pilot because they've lost jobs or housing or other points of stability in their home lives that have increased demand for HOP services.' At the same time, the disaster made it harder to provide services — housing in particular. 'Formerly, we were doing housing navigation and support for a slice of the regional population, but now we have hundreds of families competing for spaces because their housing has been damaged or lost,' Stradley said. 'So it's also harder for those folks who are already eligible to get access to some of the services like home repairs, for example, because our contractors in this region are flat out of availability.' Housing has long been one of the most difficult needs to meet in western North Carolina, owing in large part to the region's scant inventory of homes and dearth of affordable rental options. 'In the early days and the early allowances for healthy opportunities and housing, we really focused on people who were in unstable situations or unhoused,' Stradley said. 'What we're recognizing is that we need more emphasis on keeping people housed through things like home repairs and remediation.' She offered the example of a family that has a young child with asthma. 'They get home from school and by after-dinner time they're starting to have some trouble breathing and starting to have an asthma attack — and they're going to wind up in the emergency room,' she said. More: 'Onto the street': In a month, 5,000 have left FEMA Helene hotels in WNC; over 700 remain The Healthy Opportunities Pilot can help that family tackle the environmental triggers in the house — such as mold, a common problem in the mountains. The family can get as much as $2,900 to address those issues, which is about the cost of one emergency room visit. 'There's a program in that called Breathe Right that helps to remove any moldy carpet or other mold mitigation that needs to happen in the house, and brings in filters to systems and vacuums that have a HEPA filter on them, hypoallergenic covers for pillows and all those sorts of things,' Stradley said. 'And then the child will see a great decline in emotional, environmental triggers. And then they're not going to the emergency room, [instead] staying in school, all those good things.' Despite the challenges, Stradley said she's excited about the possibility of the pilot expanding to other parts of the state. 'We're already seeing indications that if we don't spend these funds on food and housing and transportation, we are going to spend these funds on clinical care, diagnosis and long-term health care,' she said. 'The more we can invest in making sure that young people have a safe place to sleep and healthy food to eat means that they are more likely to grow up and grow out of these programs.' Model for the nation The pilot is one of the first large-scale tests of whether providing nonmedical services can boost health outcomes and cut health care costs, and its results could inform Medicaid policies in other states. 'What every other state has done is really taken one specific domain and leaned in really hard,' Kinsley said, noting that initiatives in other states have focused exclusively on needs like food or housing. 'North Carolina has the widest list of services that can be paid for with these types of Medicaid dollars.' The early success of the pilot, he added, has 'given the federal government confidence that we can take this statewide and continue to push forward.' Kinsley's successor, NCDHHS Sec. Devdutta Sangvai, supports expanding the program to other regions of the state, but he said that's not going to happen overnight. 'We have this waiver now, which gives us options, and now we have to think about how we exercise the options that CMS has given us,' he said. 'It'll definitely require partnership with the General Assembly to understand where those priorities are.' 'The challenge,' he added, 'is we're not going to be able to do everything all at once, and we're not going to be able to do it at 100 percent all at once.' In the coming months, Sangvai said, he hopes to build consensus around the program, which faces an uncertain future under the new presidential administration. Trump has said little about his plans for Medicaid, but many of his cabinet appointees have signaled interest in cutting funding for the program — a move that would make pilot expansion a tougher sell for state lawmakers and force them to prioritize medical expenditures. Stradley hopes that won't happen. She believes the pilot could 'become more effective and more efficient' if it's allowed to grow. 'There will be so much more opportunity for collaboration and coordination and reduction in the sort of administrative and overhead costs that come with the early stages of a pilot,' she said. 'We hear all the time that all eyes are on us, for those of us doing this work in North Carolina, and it's true. We really are shaping the way that this can be done, and other states are going to learn from us.' More: After Helene, Asheville public housing evictions continue. Residents have 'nowhere to go' More: State lawmakers considering $500 million more in Helene aid, half of Stein's request
