Overview
This report examines the planning and early implementation of North Carolina’s Healthy Opportunities Pilots, a large-scale Medicaid initiative that connects eligible members with services addressing food, housing, transportation, interpersonal violence, and toxic stress. It offers practical lessons for states and organizations developing similar cross-sector programs at scale.
What the Resource Covers
The report draws on qualitative research conducted during the program’s planning, capacity-building, and early implementation phases. It identifies six major implementation themes, including building local community-based organization (CBO) capacity, developing sustainable funding strategies, engaging community partners, building a business case for scaling and sustaining CBO, providing training and technical assistance, and ensuring data and technology are flexible to support key cross-sector program functions. The report also discusses how program structure and payment approaches can affect participation by smaller community-based organizations.
Key Takeaways for Implementation
Cross-sector programs require infrastructure that supports both health care and community partners. The North Carolina experience highlights the importance of investing in CBO capacity, defining roles and payment arrangements, creating flexible data systems, engaging partners throughout implementation, and providing ongoing technical assistance as programs evolve.
Who May Find This Resource Useful
This resource may be especially useful for Medicaid agencies, managed care organizations, health systems, and CBOs seeking clear, practical guidance for designing and implementing cross-sector programs that connect Medicaid members with non-medical services.
Resource Type: Issue Briefs & Reports.
Topic Areas: Medicaid, community-based organizations, cross-sector partnerships, payment models, program implementation.
Population or Setting: North Carolina, with lessons applicable across states.
Publication Date: September 2023.
Source: Milbank Memorial Fund; Duke-Margolis Center for Health Policy.
