NCDHHS says Medicaid pilot reduced monthly costs
RALEIGH — A North Carolina Medicaid pilot program reduced health care costs by an average of $164 per month for participating beneficiaries, according to study results announced by the N.C. Department of Health and Human Services.
NCDHHS said the Healthy Opportunities Pilots, known as HOP, also shifted some patient care away from emergency departments and hospitals and toward less-expensive outpatient providers, including primary care practices.
The study was conducted by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. It included more than 31,000 people enrolled in the program from March 15, 2022, through Nov. 30, 2024.
The program uses Medicaid funding to pay for targeted nonmedical services tied to health outcomes, including housing, food, transportation and interpersonal safety supports. NCDHHS described HOP as the nation’s first comprehensive initiative to evaluate how Medicaid-funded, evidence-based nonmedical services affect health outcomes and Medicaid costs.
“Healthy Opportunities Pilots improved the health and well-being of participants and drove down costs for the state,” Health and Human Services Secretary Dev Sangvai said in the announcement.
According to NCDHHS, participants also reported decreases in food, housing and transportation needs. The department said monthly Medicaid savings included the cost of services and the cost of administering the program.
The federal Centers for Medicare and Medicaid Services has authorized the program to continue through December 2029. NCDHHS said most of the program is federally funded, with the state covering the remaining costs.
The department also said the General Assembly did not provide additional funding for the program after July 1, 2025, causing the program to suspend operations.
The findings come as lawmakers continue debating Medicaid spending, rural health care access and whether public health programs should focus more directly on nonmedical factors that affect health.
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.
