NC’s Healthy Opportunities Pilots Reduced Medicaid Costs by $164/Month Per Beneficiary
A recent press release from the NC Dept. of Health and Human Services shares that, “North Carolina’s innovative Healthy Opportunities Pilots (HOP) reduced health care costs by an average of $164 per month for NC Medicaid beneficiaries, according to the results of a study announced today by the North Carolina Department of Health and Human Services. The study, conducted by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, found the program led to a significant shift in patient care. HOP participants had fewer emergency department visits and hospital stays and more visits with less-expensive outpatient providers like primary care practices.“A recent press release from the NC Dept. of Health and Human Services shares that, “North Carolina’s innovative Healthy Opportunities Pilots (HOP) reduced health care costs by an average of $164 per month for NC Medicaid beneficiaries, according to the results of a study announced today by the North Carolina Department of Health and Human Services. The study, conducted by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, found the program led to a significant shift in patient care. HOP participants had fewer emergency department visits and hospital stays and more visits with less-expensive outpatient providers like primary care practices.“
NCDHHS Selects Impact Health as Region 1 NC ROOTS Hub Lead
On May 1st, the North Carolina Department of Health and Human Services announced that Impact Health would serve as the Region 1 lead for the North Carolina Rural Organizations Orchestrating Transformation for Sustainability (ROOTS) Hub for the state’s Rural Health Transformation Program (NCRHTP). These Hubs will act as regional networks connecting medical, behavioral health, and social supports as North Carolina increases access to care for rural communities across all 100 counties.
Medicare Advantage at a Crossroads: Incentives, Access, and the Future of Care
Medicare Advantage (MA), also known as Part C, has become the dominant path through which older adults receive Medicare coverage. More than half of all beneficiaries — roughly 33–34 million people — are enrolled in plans operated by private insurers. These plans promise convenience and financial protection, including caps on out‑of‑pocket spending and some extra benefits not found in Original Medicare. At the same time, MA brings challenges that stem directly from how the program is designed, and these structural incentives can affect access to timely care, especially for people with complex health needs or limited provider options.
CMS’s Rural Health Funding Announcement - Key Takeaways
On September 15, 2025, CMS released a Notice of Funding Opportunity (NOFO) for the Rural Health Transformation Program outlining key requirements, deadlines, and criteria that states will need to apply for this funding, which is intended to support improvements to rural healthcare systems as well as health outcomes in rural areas. In this article, we share key takeaways from this announcement.
NC DHHS’ 1115 Waiver Renewal Approved to Continue and Expand NC Healthy Opportunities Pilots and Other Programs
In December, 2024, CMS approved a new 1115 waiver renewing funding and expansion opportunities for several programs, including the successful NC Healthy Opportunities Pilot, which uses Medicaid funds to provide social determinants of health interventions such as housing, food, transportation and other supports to Medicaid beneficiaries as a cost-savings measure to improve health outcomes and to prevent or manage chronic disease.