Washington, D.C. – The federal Medicaid program offers critical health coverage for millions of low-income Americans, but many beneficiaries still face persistent health problems due to social and structural barriers such as food and housing insecurity; access to quality education; and access to clean air, land, and water.
A new report from the Center for American Progress shows how North Carolina has leveraged Medicaid to develop a large-scale, comprehensive approach to address these non-medical factors affecting health, including food, housing, and transportation insecurity.
The state’s new Healthy Opportunities Pilots program works to improve health by addressing these issues. It embeds a standardized screening process, a referral and feedback system, care management, and enhanced programming within the Medicaid program that build on existing infrastructure in coordinated care and social services.
To qualify for the program, participants must have at least one health risk factor, such as adults with two or more chronic conditions or repeated emergency room visits, and one social risk factor, such as homelessness or food insecurity.
“Addressing the underlying social and economic factors that lead to health issues and health disparities not only improves equity, it also can result in savings,” said Nicole Rapfogel, research associate for Health Policy at CAP and co-author of the report. “Developing the infrastructure and payment incentives to identify needs and coordinate services can prevent more dire health problems, reducing hospital admissions and readmissions and emergency care for acute health crises.”
If the North Carolina program sees savings and/or improved outcomes, it may serve as a model for other states and other regions in North Carolina to replicate the program, the report finds.
Read the report: “North Carolina’s Medicaid Approach to Social Determinants of Health,” by Nicole Rapfogel and Jill Rosenthal
Read a fact sheet describing the program: “How North Carolina Is Addressing Social Determinants of Health Through Medicaid”
For more information, or to speak with an expert, please contact Sam Hananel at [email protected].