05/31/2026
North Carolina’s Healthy Opportunities Pilots (HOP) tested whether addressing non-medical social needs — food insecurity, housing instability, transportation, and interpersonal violence — could improve health outcomes and reduce costs for Medicaid beneficiaries, particularly in rural areas. Running from March 2022 through November 2024, the program enrolled 31,597 individuals and delivered over 691,000 services through a network of community-based organizations across three regional pilot areas. Food services made up the large majority of services provided.
The results were largely positive. Pilot participants showed reduced emergency department visits, fewer inpatient admissions, and increased outpatient care. Healthcare spending was estimated to be about $164–$231 lower per member per month when accounting for program costs. Participants also self-reported meaningful improvements in health and quality of life, with many describing the program as transformative. While some clinical outcomes like blood pressure and birth weight didn’t show measurable change, the overall findings support the core premise: that meeting people’s social needs is an effective strategy for improving health and reducing healthcare costs.
View the full report here and read more at the NCDHHS’ Healthy Opportunities Pilots site
