By WECT Staff | May 27, 2021 at 4:40 PM EDT – Updated May 27 at 4:40 PM
RALEIGH, N.C. (WECT) – The North Carolina Department of Health and Human Services (DHHS) announced Thursday it had selected organizations that would pilot a national comprehensive program in three North Carolina regions to test evidence-based, non-medical interventions designed to be a cost-efficient way to improve the health of Medicaid beneficiaries.
Community Care of the Lower Cape Fear will operate the Healthy Opportunity Pilot program in the southeastern region, an area that includes Bladen, Brunswick, Columbus, New Hanover, Pender, and Onslow counties.
Research has shown that 80 percent of a person’s health is determined by social and environmental factors and how these impact behavior.
The Healthy Opportunity program will create a systematic approach to integrating and financing non-medical services that address housing stability, transportation access, food security, and interpersonal safety into the delivery of health care.
The former director of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, referred to the approach as “groundbreaking.”
“As we seek to create a health care system that truly rewards value, we must consider the impact that factors beyond medical care have in driving up health costs,” said Verma.
The Healthy Opportunities pilots were approved in 2018 as part of the state’s waiver to transition to Medicaid Managed Care.
“North Carolina continues to lead in innovative approaches to build a well-coordinated system of care that addresses both the medical and non-medical drivers of health,” said DHHS Secretary Mandy K. Cohen, M.D.
The pilot studies will test the impact of providing non-medical interventions to high-needs Medicaid enrollees over the next five years; $650 million in Medicaid funding has been allocated to the pilots by the federal government.
To be eligible for and receive pilot services, NC Medicaid Managed Care members must live in one of the three selected regions, have at least one qualifying physical or behavioral health condition, and have one qualifying social risk factor.
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