North Carolina’s ‘Truly Innovative’ Pilot Helps High-Risk Medicaid Beneficiaries

A program that provides non-medical interventions for North Carolina’s high-risk Medicaid population resulted in cost savings and fewer hospitalizations, according to a third-party analysis and speakers who participated in a recent Manatt, Phelps & Phillips LLP webinar. Heidi Chan, market president for AmeriHealth Caritas, said the Healthy Opportunities Pilots (HOP) “is truly an innovative program” and helps provide “whole-person care” for vulnerable beneficiaries who suffer from food, housing and transportation insecurity. 

Kody Kinsley, secretary of the North Carolina Dept. of Health and Human Services (NCDHHS), added that the state launched the HOP in March 2022 as part of a CMS Section 1115 waiver amid the state’s push to better serve rural and low-income residents. The state also expanded Medicaid eligibility starting in July 2021 to people between 19 and 64 years old with incomes up to 138% of the poverty level.