Healthy Opportunities Pilots at Work
The Healthy Opportunities Pilots have had a marked impact on the lives and wellbeing of North Carolinians. NC DHHS has compiled key metrics, media stories and member stories which reflect the impact HOP has on individuals and their communities.
Key Metrics
| Number of Enrollees | 21,401 |
|---|---|
| Percent of Service Authorizations Approved | 80% |
| Number of Services Delivered | 337,657 |
| Number of Invoices Submitted | 358,247 |
| Percent of Invoices Accepted, Paid, or In Progress | 95% |
| Amount Paid for Service Delivery | $60,902,248 |
*Data through March 31, 2024
Number of HOP Enrollees includes all members enrolled in HOP, beginning March 15, 2022.
Healthy Opportunities Pilots in the News
- NC Medical Journal: Reflecting on Nearly Two Years of North Carolina’s Healthy Opportunities Pilots
- NC Medical Journal: Integration of Social Service Delivery with Health Care - A Foundation’s Role in North Carolina’s Healthy Opportunities Pilot Program
- STAT: In North Carolina, a radical experiment targets social determinants of health with fresh produce and safe housing
- Milbank Memorial Fund: Addressing Social Needs through Medicaid: Lessons from Planning and Early Implementation of North Carolina’s Healthy Opportunities Pilots
- Harvard Public Health: North Carolina’s radical Medicaid reinvention
- Health Affairs: CMS Approves NC’s Innovative Medicaid Demo
- Health Affairs: Buying Health for North Carolinians (Mandy Cohen)
- NY Times: Inside NC’s Big Effort to Transform Health Care
- KFF: A First Look at NC’s 1115 Waiver’s Healthy Opportunities Pilots
- CMWF: Buying Health, Not Just Health Care: NC’s Pilot Effort
- NC Health News: “It’s Never Been Done Before…”
- ABC: WNC part of 'groundbreaking' pilot addressing social, environmental health determinants
- The Assembly: A Radical Way To Think About Health
- Manatt article - A First Look: Highlights From North Carolina’s Healthy Opportunities Pilots
Success Stories
Read more about the positive impact of Healthy Opportunities Pilots on the lives of North Carolinians in the following success stories.
Restoring A Family’s Feeling of Safety
A family experiencing homelessness due to interpersonal violence-related challenges was living in a shelter. A HOP organization, with the shelter's assistance, was able to help the family find safe, affordable housing. The coordination of supports, including HOP services, was used to assist the guardian with securing a job and childcare within two weeks of living in the shelter.
Shortly after being housed, the family was given a donated car with new tires and full insurance coverage paid up for 6 months by a local church. The HOP organization was also able to find an individual willing to teach the member basic self-defense at no charge. Currently, the family is happily housed, employed, and no longer has a fear of feeling unsafe.
HOP Helps Keep the Lights On
A mother participating in HOP owed payment on her utility bill, which led to her family’s electricity being shut off. A HOP organization and the mother’s Care Management team worked together to explore all resources - both HOP and health plan-related - to ensure the mother and her children were set up with a housing stability and utility payment plan.
The family’s electricity was restored after being cut off for approximately 34 days. The HOP “essential utility” service and a payment plan with the utility company now have the family in a stable place. The HOP team continues to monitor and support her as she navigates her current housing situation and her new employment.
Utility Assistance for a Grandmother
Following the death of his father, a child enrolled in Medicaid was placed under the guardianship of his grandmother, who moved into her recently deceased son’s home to care for her grandson. Soon after moving into the home, she learned there was an outstanding utility bill of $1,000.
The grandmother found herself two months behind on payment and at risk of having the utilities cutoff. A care manager referred the child’s grandmother for utility assistance through the Healthy Opportunities Pilots, which was approved for $500, the full amount allowed. This assistance cut the total bill in half and drastically reduced the financial burden and stress on the child and his grandmother.
Keeping the Family Together
A single mother had been staying at a local shelter with her children but needed life-saving surgery. Her children couldn’t remain in the shelter without her, which left her in an impossible position. Mom had secured an emergency housing voucher, but it wasn’t enough to cover rent in the county where she would be receiving treatment.
Through the Healthy Opportunities Pilots, her care managers were able to help her transfer her housing voucher and secure income-based housing near the hospital. They also helped her access financial support for her security deposit and utility setup fees – all services that are covered for the Healthy Opportunities Pilots participants.
Now, mom is able to focus on her health, schedule needed medical care, and keep her family together under one roof with help from her friends and the Healthy Opportunities Pilots.
Healthy Food Boxes ‘Total Gamechanger’ for Family
An enrollee reported that after just a few weeks the Healthy Opportunities Pilots have had a tremendous impact on everyone in her home. She expressed appreciation for access to fresh and nutritious food, which had previously been challenging to obtain. The enrollee and her family faced physical and financial barriers to accessing the food necessary for her dietary requirements and often relied on less nutrient-dense options.
With access to better foods, the family is now eating well and meeting their nutritional needs. They all have more energy, cheerful moods and feel much better physically. The enrollee even reported that her “husband is excited about coming home for supper these days! He is so happy about the variety and colorful options” and they “have all come together more as a family to eat again.”
The enrollee stated that this is a “small joy in [my] heart, that as a mother, [I don’t] have to worry about how [I’m] going feed my family. No one should ever have that burden on their heart.”
This page was last modified on 04/19/2024