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.“

WNC is home to many innovative strategies for navigating complex health challenges.

Two of those include the role of Community Health Workers in the healthcare workforce and the Healthy Opportunities Pilot, which abruptly ended in the summer of 2025 due to the General Assembly's failure to pass a budget. 

In this episode we hear from Jacque Ballard, a community health worker who has worked in both Madison and Yancey Counties and recently supported research by the Health Policy Research Consortium to understand the impact of HOP's end. We talk about the work of community health workers, challenges experienced in WNC, and the impact of HOP's end.

“The Root of Good Health” documentary, produced by Resource Rural and in partnership with Beacon Media and Carolina Forward, shares stories that illustrates the good that North Carolina’s Healthy Opportunities Pilot (HOP) has done for Western North Carolina — as well as the cost to the region, the people it served and the local businesses and organizations it supported as a result of losing this program due to North Carolina’s ongoing stalled budget negotiations.

In this episode we speak with Paula Swepson Avery and Ginger Webb from West Marion Inc. about their decade-long journey of community transformation in McDowell County. They tell us how meaningful progress requires long-term commitment, not constantly shifting strategies, and how their work centers on addressing the social determinants of health, like housing, transportation, food access, childcare, and stigma in their WNC community.

Family, Friend, and Neighbor care represents one of the most widely used forms of child care, yet it is frequently excluded from policy conversations and funding priorities. FFN childcare is not just a preference; it is a form of community resilience in the face of constrained resources that supports child welfare and education, allows parents to stay in the workforce, and creates jobs within the community. As sustaining resources for our communities, FFN providers must be supported with the tools, resources, and investments they need to thrive while exploring strategies to navigate the larger concerns of our childcare shortage. The Western North Carolina Family, Friend, and Neighbor (FFN) research project, a partnership between the  NC Center for Health and Wellness(NCCHW) at UNC Asheville  and Smart Start of Transylvania County, provides critical insight into one frequently overlooked component of our regional infrastructure.

Nicole Hinebaugh, Director of the The Smoky Mountain Harvest Hub in Haywood County, NC, joins the WNC Health Policy Initiative podcast to share how food hubs work, why they matter, and the impact of this kind of public investment. Topics discussed include how food-based health interventions already show a strong financial return on investment, how food hubs create stable markets for small family farms, what recent food insecurity data tells us about the urgency of action and why supporting local food systems is essential to economic recovery, disaster resilience, and mental health.Add excerpt here

North Carolina ranks 41st nationally on Long-Term Services and Supports, reflecting the fragmented system of care that many residents in WNC and across the state face when seeking help. For many people across North Carolina, and especially in Western North Carolina (WNC), finding help can feel like navigating a maze. Whether someone is seeking support for aging in place, disability services, caregiving, housing stability, or recovery, the system often requires knocking on multiple doors before finding the right one.

The No Wrong Door framework was created to address this challenge. Guided by the Administration for Community Living, No Wrong Door is not a single program, technology platform, or intake system. Instead, it is a framework that helps states align governance, outreach, counseling, and access points so individuals can more easily find and receive the resources, information and help they need.

North Carolina ranks 41st nationally on Long-Term Services and Supports, reflecting the fragmented system of care that many residents in WNC and across the state face when seeking help.

In this episode, we discuss the No Wrong Door (NWD) framework and how North Carolina is using it as a roadmap - although not yet a fully built system - to better coordinate services statewide, including in Western North Carolina.

Join us as we continue our exploration of the WNC Health Policy Initiative's collaborative study, “Lessons Learned from the Healthcare Response to Hurricane Helene” with researchers Alex Mitchell and Soni Pitts as they examine how healthcare leaders in Western North Carolina responded to the crisis.

In Part 3 of our podcast series, hear from the research team about what worked, what didn’t, and the practical recommendations health care leaders say are needed to strengthen Western North Carolina’s disaster preparedness moving forward.

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.

In the wake of the hurricane, the NC Center for Health and Wellness and Social Bridging NC have produced two resources to support older adults and others affected by this event across the region, including responders and others working on the relief efforts: A webpage of curated long-term resources and a mini-guide of best practices for providing trauma-informed support through wellness checks in person or by phone.

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.

The WNC Health Policy Initiative has held several listening and working sessions relating to the needs and challenges facing aging adults, children in the foster care system, and affordable housing. Bridge Meadows, a multigenerational housing community in Oregon, offers an example of how to build intersectional, supportive environments to address these and other such issues.

Identifying and implementing a long-term plan to create a sustainable, well-funded child care system in North Carolina is critical to avoiding the severe negative impacts that losing this critical infrastructure would create, and is a priority focus area for the WNC Health Policy Initiative.

The WNC Early Childhood Coalition, a key partner in the WNC HPI’s Early Childhood Education workgroup, has launched their Yes On Child Care campaign to boost awareness of these issues and to provide opportunities for engagement and advocacy.

A new initiative launched by the Mountain Area Health Education Center (MAHEC), co-host of the WNC Health Policy Initiative, offers an innovative housing solution for medical residents serving in rural Western North Carolina - purpose-built, energy-efficient tiny homes placed exactly where they’re needed most.

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. 

Facing a dramatically shrinking healthcare workforce, Western North Carolina has identified innovative ways to support and expand the influence of a key role for increasing access among those most vulnerable and most often left behind - Community Health Workers.

North Carolina Community Health Worker Association President, Honey Yang Estrada talks about the role of Community Health Workers in increasing healthcare access, reducing healthcare workforce strain and improving public health at the community level.

On May 30, 2024, the Department of Health and Human Services, through its Administration for Community Living, released its “Aging in the United States: A Strategic Framework for a National Plan on Aging” report, which “lays the groundwork for a coordinated effort…to create a national set of recommendations for advancing healthy aging and age-friendly communities that value and truly include older adults.”