North Carolina State Transformation Collaborative

Latest Updates
Alignment Proposal
The North Carolina State Transformation Collaborative (NC STC) has issued its “Alignment Proposal: Action to Advance Whole-Person Care in North Carolina,” which provides a practical, action-oriented vision to advance the health and well-being for North Carolinians while supporting its health care workforce. More than 30 health care, community, and state organizations serving all 100 counties in North Carolina have endorsed this proposal. Click here to read it.
Background
The North Carolina State Transformation Collaborative (NC STC) was launched in February 2023 as a public-private partnership designed to promote high-value and whole-person care through multistakeholder partnerships. North Carolina is one of four states participating in the STC initiative, initially launched by the Health Care Payment Learning and Action Network (HCP-LAN) and the Centers for Medicare & Medicaid Services (CMS). In North Carolina, the STC is financially supported by the North Carolina Department of Health and Human Services (NCDHHS) with Duke-Margolis serving as the neutral convener. The NC STC represents a collective effort to shift from paying for health care services through a fee-for-service model to investing in health with a value-based, whole-person approach.
Since its launch, Duke-Margolis, in partnership with NCDHHS, established technical working groups and gathered strategic feedback to build a path forward to advance the NC STC goals across key priority areas: aligning quality measurement, strengthening coordinated and accountable primary care, enhancing health disparities data, and improving data exchange to enable advanced coordinated care models, starting with coordinated and accountable primary care. The image below summarizes the framework for North Carolina’s State Transformation Collaborative, including goals, key strategies, and approaches to achieve high-quality and whole-person care.

The Value of the NC STC: Coordinating Across Other NC and Federal Initiatives
The NC STC leverages multistakeholder collaboration to advance shared goals of improving population health, addressing health disparities, enhancing patient experience, relieving provider burden, and reducing costs. These goals align with North Carolina’s significant investments in creating a whole-person system of care through Medicaid Transformation and other state transformation initiatives efforts like Medicaid Expansion in 2023, the Healthy Opportunities Pilots, landmark investments in behavioral health, the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan Launch, and the Primary Care Payment Reform Taskforce.
Transforming the health care system requires collaboration in multiple levels, including the patients, providers, payers, and state the federal agencies. The NC STC brings people together to address common challenges experienced across these disparate health transformation initiatives. There are opportunities to extend learnings from the NC STC state initiatives to further state and federal goals and make progress on health reform efforts.
More about the NC STC
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History of the NC STC
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Stakeholder Engagement
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Key Resources
Summary of STC Activities
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Launch of the NC STC
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Convening the NC Health Care Transformation Workgroup
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Convening the NC STC Data Sharing Workgroup
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The Alignment Proposal for the NC STC
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NC STC June 2025 Public Meeting
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Convening the NC STC Health Disparities Data Workgroup
Key Areas to Operationalize NC STC Strategies
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Strategy #1: Align Quality Measures
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Strategy #2: Improve Data Sharing Infrastructure
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Strategy #3: Enhance Health Disparities Data
Stakeholder Engagement Opportunities through the NC STC
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Join the Collaborative's Newsletter
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Newsletter Archive
Duke-Margolis Project Team
Catie Armstrong, MPH
Policy Analyst

Emily Proehl, MPH
Policy Analyst

Samantha Repka, MS
Research Associate

Robert Saunders, PhD
Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Executive Team Member
Margolis Core Faculty

Brianna Van Stekelenburg, MPP
Research Associate

Rebecca Whitaker, PhD, MSPH
Research Director, North Carolina Health Care Transformation
Core Faculty Member
Senior Team Member