Thanks to predicted funding cuts in NC’s Medicaid rebase, NC DHHS implemented a series of sweeping cuts to adjust for the shortfall. Under the announced plan, nearly all Medicaid providers will face rate reductions of 3 percent to 8 percent, while some categories — including nursing homes, hospitals, psychiatric residential treatment facilities and certain ambulatory services — will see steeper cuts of up to 10 percent. 

The reductions will affect services across the board, from personal care and home health to outpatient therapy and hospital care.

Health policy doesn’t happen in a vacuum—it’s the product of political negotiation, lobbying, legislation and often a delicate balance of regional interests. On a recent episode of the WNC Health Policy Initiative Podcast, we had the opportunity to sit down with Jackson County’s own Dr. Chris Cooper, Robert Lee Madison Distinguished Professor and Director of the Haire Institute for Public Policy Western Carolina University at Western Carolina University, and author of Anatomy of a Purple State, to take a deeper look at the dynamics shaping health policy in North Carolina today. In this article, we explore the current background and landscape of health policy in North Carolina touched on by Dr. Cooper, as well as review some of the relevant legislation coming up on the NC General Assembly’s consideration in the coming months.

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.

On July 4, 2025, Donald Trump signed the “One Big Beautiful Bill Act,” or H.R.1, into law. The funding cuts and policy changes embedded in this sweeping legislation could reshape healthcare access across Western North Carolina. Join us as we sit down with Katie Alexander and Ali Houghton from Pisgah Legal Services to discuss this controversial piece of federal legislation and gain insight into what it could mean for healthcare access in WNC.

On July 4, 2025, Donald Trump signed the “One Big Beautiful Bill Act,” or H.R.1, into law. The funding cuts and policy changes embedded in this sweeping legislation could reshape healthcare access across Western North Carolina. WNC HPI sat down with Katie Alexander and Ali Houghton from Pisgah Legal Services to discuss this controversial piece of federal legislation and gain insight into what it could mean for healthcare access in WNC.

In this series, the Western North Carolina Health Policy Initiative podcast explores the Healthy Opportunities Pilot program from a few perspectives to help educate our listeners and policymakers about what's on the table in light of state budget cuts to the program. In this installment, we hear about the impact of the HOP from the perspectives of the WNC network lead, a participating HSO, and two families with children enrolled.

This summer, North Carolina's House and Senate will be working to finalize our biennial budget on June 30th, beginning July 1st, 2025 and covering the next two fiscal years. Inside this budget is the fate of what's known as an Innovative Pilot Program across three regions, including Western North Carolina: the Healthy Opportunities Pilot, a program that uses Medicaid funding to address some upstream health issues like food access, transportation, housing, and interpersonal violence. By addressing these root issues, the program hopes to both improve health outcomes for North Carolinians, saving them and the state money. In this short series of the Western North Carolina Health Policy Initiative podcast, we'll be taking a look at this pilot program from a few perspectives to help educate our listeners and policymakers about what's on the table. Today we'll look at an evaluation of HOP to better understand how the program is working and its impact on the state's bottom line.

A new study recently published in the Journal of the American Medical Association demonstrates that Medicaid beneficiaries enrolled in NC’s Healthy Opportunities Pilot (HOP) showed an overall decrease in Medicaid spending compared to non-HOP enrollees and reduced utilization of emergency services - all indicators that correlate to improved health outcomes.

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.

Dec. 1, 2024 marks the first anniversary of Medicaid expansion in North Carolina, which has expanded affordable health care coverage to nearly 600,000 North Carolinians. Learn how NC Medicaid expansion has impacted access to health care in your county, and join us in celebrating this landmark health policy milestone in NC.

The Duke-Margolis Institute for Health Policy has just published a Community Fact Sheet summarizing the findings of their research paper exploring the design and implementation of, and lessons learned from, the delivery of housing support services via NC Medicaid's Healthy Opportunities Pilot as a way to reduce healthcare costs and improve health outcomes and quality of life for recipients.

Across America, 41% of adults struggle with medical bills they cannot pay, a situation that comes with significant financial, emotional and even physical costs, including reduced access to necessary healthcare. On July 26th, 2024 North Carolina Governor Roy Cooper and the NC Department of Health and Human Services took a huge step toward alleviating that burden with the introduction of the Medical Debt Relief Incentive Program, which will eliminate medical debt for millions of Medicaid recipients and middle- and low-income residents across the state. 

Learn more about North Carolina efforts to address health-related social needs via Medicaid and CHIP that are paving the way for a new approach to preventive healthcare and chronic disease management via non-medical social interventions, and that could serve as models for other states and Medicaid programs interested in exploring ways to address health-related social needs.

Social drivers or social determinants of health are the nonmedical conditions and experiences that help contribute to a person's whole wellbeing. In this episode of the HPI podcast, we’ll be learning about the Healthy Opportunities Pilot, a program that uses Medicaid funds to address critical housing, food security, transportation, safety needs of qualifying individuals. Expected to be expanded in November of 2024, this pilot represents a new direction for healthcare funding in N.C. and may influence health policy nationwide.

North Carolina’s Healthy Opportunities Pilot - an innovative program designed to use Medicaid funds to improve health outcomes and reduce healthcare costs by addressing social determinants of health - is making the news…and making a difference.