North Carolina’s Efforts to Advance the State’s Health Care Transformation Pick Up Speed

Durham, NC— One year ago, North Carolina launched a state-funded initiative to improve the health of North Carolinians. On May 23, 2024, representatives from NC Department of Health and Human Services (NCDHHS) and the private sector will hold a hybrid public meeting at Duke University to assess progress to date and discuss what needs to happen next to leverage the state’s commitment to enhancing health care access and quality through recent efforts like the Primary Care Payment Reform Taskforce, Medicaid Expansion, and the broader Medicaid transformation in the state.  

“North Carolina is a national leader in shifting from paying for health care services to buying health,” said Dr. Elizabeth Cuervo Tilson, State Health Director and Chief Medical Officer of NCDHHS. “This effort matters to North Carolinians because it holds the promise of supporting whole-person care statewide—that is, physical, behavioral, and social health—so all people have the opportunity for health in North Carolina.”

The Duke-Margolis Institute for Health Policy will gather state health care leaders for the North Carolina State Transformation Collaborative (NC STC), an initiative led by the NCDHHS, the Centers for Medicare & Medicaid Services (CMS), the Health Care Payment Learning and Action Network, and Duke-Margolis. The NC STC steers health care reform efforts and seeks to remove burdens that inhibit North Carolina’s health care providers from caring for the whole-person and addressing individuals’ health and social resource needs.

“This public event is geared toward sharing practical strategies and actionable steps to ensure statewide implementation of proven policies and initiatives that advance health and well-being for individuals, communities, and populations across North Carolina,” said Kate Davidson, Director of the Learning and Diffusion Group, CMS Center for Medicare and Medicaid Innovation.

North Carolina’s Medicaid expansion, launched in December 2023, is already helping nearly 500,000 more North Carolinians access health insurance coverage and needed health and social services. A focus on extending accountable and advanced primary care models to the newly insured population can help give health care providers and patients access to resources to better manage their care when and how they want to, including through virtual visits. One example is NC Medicaid’s $650 million investment in its Healthy Opportunities Pilots, which are creating a national model for how the health and social care workforce collaborate to address social determinants of health, such as housing and food insecurity.

“The NC STC brings the power of collaboration to health care reform in the state,” said Dr. Mark McClellan, Director of Duke-Margolis. “Many transformational efforts are taking place in North Carolina, thanks to the leadership and commitment of clinicians, health care organizations, businesses and communities—the STC helps them reach practical solutions together to the common challenges they each face alone.”

The scope of the NC STC work is innovative but complex, and fulfilling its potential for North Carolinians has challenges. Specifically, North Carolina health care leaders need help streamlining how these health reform programs are implemented in order to support the health care and social service system’s capacity to provide whole-person care, reduce time spent by providers on administrative tasks so they can focus on their patients, and measure the state’s progress toward its health reform goals. Health care leaders also need support to address longstanding health disparities in the state through improvements in how health equity data is collected, used, and shared to improve health.

“Alignment Proposal for the North Carolina State Transformation Collaborative: A Pathway to Advance Whole-Person Care,” released as part of this public meeting, details next steps to further progress toward better health care delivery in the short- and long-term, specifically prioritizing key primary care and prevention clinical areas in need of improvement, such as diabetes and heart disease, and the data tools to facilitate the right care, at the right time, for the right patient. 

In the next phase, the NC STC will expand stakeholder engagement to include community-based organizations and people with lived experience to develop guiding principles and best practices for identifying and addressing longstanding health disparities in North Carolina.

“The NC STC has made great strides in the past year, but we have more work to do to realize true whole-person health for the people of North Carolina,” Dr. Rebecca Whitaker, Duke-Margolis Research Director, North Carolina Health Care Innovation & Medicaid Transformation. “We need further engagement and support from health care payers and providers, state government, community-based organizations, and groups focused on health equity to continue this work—and we look forward to engaging them at our May 23 meeting.”

The May 23 STC public meeting will be held 3:00–5:00 pm in-person in the Geneen Auditorium, Fuqua School of Business at Duke University, and virtually via Zoom link. To attend, please register here.

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