Healthy Opportunities Pilots Deliver Nearly 24,000 Services to NC Medicaid Beneficiaries

Nearly 24,000 services have been delivered to nearly 3,000 NC Medicaid beneficiaries as part of the Healthy Opportunities Pilots since the program began in March 2022.

Nearly 24,000 services have been delivered to nearly 3,000 NC Medicaid beneficiaries as part of the Healthy Opportunities Pilots since the program began in March 2022.

The Healthy Opportunities Pilot is an innovative program that has been described as a “game changer” for thousands of North Carolina families. The program addresses non-medical drivers of health and covers the cost of 29 services outlined in the Department’s Pilot Service Fee Schedule. These services address beneficiaries’ food, housing, transportation and interpersonal violence/toxic stress needs.

One North Carolina mother wrote to DHHS after receiving food services saying that now she doesn’t “have to worry about how [I’m] going to feed my family. No one should ever have that burden on their heart.” Another man tells DHHS the Healthy Opportunity Pilots changed his life after receiving help with transportation and heating assistance. 

On average, each Pilot member has received more than eight services, with food services making up the majority. With housing and transportation services increasing, the number of Medicaid members receiving Pilot services continues to rise quickly and increased over 90% between September and December 2022.

With the Pilot program now underway, the Department is focused on rapid cycle assessments of what is working and what is not working for stakeholders throughout all Pilot regions. One area of focus since launch has been to increase awareness of and increase access to Pilot services. In partnership with Pilot entities, the Department has identified several coordinated strategies to grow Pilot enrollment and referrals over the next several months to ensure eligible North Carolinians receive the services that can improve their health. Strategies include direct outreach and streamlining the enrollment and referral process made by health plans, network leads, and human services organizations to likely-eligible members.

Healthy Opportunities Pilot services are available to qualifying NC Medicaid Managed Care Standard Plan beneficiaries in 33 counties in North Carolina. To be eligible for Pilot services, NC Medicaid Managed Care beneficiaries must live in a Pilot region and have at least one qualifying physical or behavioral health condition and one qualifying social risk factor.

To learn more about the Healthy Opportunities Pilots and how the program is benefiting Medicaid members in North Carolina, visit the Healthy Opportunities Pilots webpage or the Healthy Opportunities Frequently Asked Questions.

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