NCDHHS says Healthy Opportunities Pilots reduced Medicaid costs

RALEIGH — A North Carolina Medicaid pilot program that pays for services tied to food, housing, transportation and personal safety reduced health care costs by an average of $164 per month for participating beneficiaries, according to the N.C. Department of Health and Human Services.

NCDHHS announced the results June 2, citing a study conducted by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. The department said participants in the Healthy Opportunities Pilots had fewer emergency department visits and hospital stays and more visits with lower-cost outpatient providers, including primary care practices.

The study included more than 31,000 people enrolled from March 15, 2022, when the program launched, through Nov. 30, 2024. NCDHHS said participants also saw decreases in food, housing and transportation needs.

The Healthy Opportunities Pilots were designed to test whether Medicaid funding could be used for targeted, evidence-based nonmedical services that affect health outcomes. NCDHHS describes the program as the nation’s first comprehensive initiative of its kind.

Health and Human Services Secretary Dev Sangvai said in the announcement that the program improved health and well-being while reducing costs for the state. Melanie Bush, deputy secretary of NC Medicaid, said the program also kept dollars local and supported community-based services.

The department said the Centers for Medicare and Medicaid Services authorized the program to continue through December 2029. Most of the program is federally funded, with the state covering the remaining costs.

NCDHHS also said the General Assembly did not provide additional funding for the program after July 1, 2025, causing operations to be suspended.

Editor’s note: This article was drafted with the assistance of artificial intelligence and was reviewed and fact-checked by a member of the NC Political News editorial team before publication.