Delivering Non-Medical Services for Medicaid Members through the Access East Healthy Opportunities Pilot.

The Healthy Opportunities Pilot (HOP) is a groundbreaking pilot program that will work in conjunction with the state’s transition to NC Medicaid Managed Care to test and evaluate the use of Medicaid to pay for a select set of evidence-based interventions designed to address non-medical factors that drive health outcomes and costs. The Pilot will focus on four areas called domains: food, housing, interpersonal violence/toxic stress and transportation services.

Access East is 1 of 3 Network Leads on the Pilot. Access East covers the Northeastern North Carolina Region. This region consists of the following 9 counties: Beaufort, Bertie, Chowan, Edgecombe, Halifax, Hertfort, Martin, Northampton and Pitt. Access East has partnered with Human Service Organizations (HSOs) in each of these counties to provide support in all aspects of the Pilot program operations and delivery of services.

There are 3 goals DHHS would like to achieve from The Healthy Opportunities Pilot:

Evaluate the effectiveness of select, evidence-based, non-medical interventions and the role of the Healthy Opportunities Network Lead in improving health outcomes and reducing health care costs for high-risk NC Medicaid Managed Care members

Leverage evaluation findings to embed cost-effective interventions that improve health outcomes into the Medicaid program statewide, furthering NCDHHS’ goals for a sustainable Medicaid program.

Support the sustainability of delivering non-medical services identified as effective through the evaluation, including by strengthening capabilities of HSOs and partnerships with health care payers and providers