Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina’s Healthy Opportunities Pilots Program

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Journal Article

Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina’s Healthy Opportunities Pilots Program

Published date

February 5, 2024

Abstract:

North Carolina Medicaid’s Healthy Opportunities Pilots program is the country’s first comprehensive program to evaluate the impact of paying community-based organizations to provide eligible Medicaid enrollees with an array of evidence-based services to address four domains of health-related social needs, one of which is housing. Using a mixed-methods approach, we mapped the distribution of severe housing problems and then examined the design and implementation of Healthy Opportunities Pilots housing services in the three program regions. Four cross-cutting implementation and policy themes emerged: accounting for variation in housing resources and needs to address housing insecurity, defining and pricing housing services in Medicaid, engaging diverse stakeholders across sectors to facilitate successful implementation, and developing sustainable financial models for delivery. The lessons learned and actionable insights can help inform the efforts of stakeholders elsewhere, particularly other state Medicaid programs, to design and implement cross-sectoral programs that address housing-related social needs by leveraging multiple policy-based resources. These lessons can also be useful for federal policy makers developing guidance on addressing housing-related needs in Medicaid.

 

Read the full paper here.

Duke-Margolis Authors

William K. Bleser - Margolis headhot

William K. Bleser, PhD, MSPH

Research Director, Health Care Transformation for Social Needs and Health Equity
Senior Team Member
Anti-Racism and Equity Committee Member

Katie Huber

Katie Huber, MPH

Senior Policy Analyst

headshot Vibhav Nandagiri

Vibhav Nandagiri, BA '25

Margolis Scholar
2023 Margolis Intern

Yolande Pokam Tchuisseu

Yolande Pokam Tchuisseu, MSc

Senior Policy Analyst

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Senior Team Member
Margolis Core Faculty

Andrea Thoumi headshot

Andrea Thoumi, MPP, MSc

Area Lead, Community Health and Equity
Faculty Director of Health Equity Educational Programming
Senior Team Member
Anti-Racism and Equity Committee Member
Core Faculty Member
Adjunct Assistant Professor
2020 Intern Mentor

Rebecca Whitaker Headshot

Rebecca Whitaker, PhD, MSPH

Research Director, North Carolina Health Care Transformation
Core Faculty Member
Senior Team Member
Anti-Racism and Equity Committee Member