North Carolina is a leading national model for the shift from “paying for health care services” to “paying for health.” In the past five years, North Carolina policymakers and health care leaders have implemented significant bipartisan health reforms, leading the nation in building innovative programs and supporting infrastructure, especially related to addressing children and families’ health and resource needs (e.g., housing, food) through coordinated, cross-sector models.

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This Emerging Initiative is built on foundational work, including these Issue Spotlights:

North Carolina Integrated Care for Kids

Practical Lessons for Implementing the Healthy Opportunities Pilots

Duke Primary Care Transformation Initiative

NC State Transformation Collaborative

A federally funded, child-focused health care delivery and payment pilot aims to advance better long-term health outcomes for children and families through care models and payment mechanisms that identify children who are at risk of poor health outcomes earlier, and making these models an integral part of Medicaid reform.

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More Information:

Emerging Initiative - Expanding and Spreading State-Based Transformation in and Beyond North Carolina to Improve Health in the South

NC InCK webpage

In one of the first U.S. programs of its kind, North Carolina’s $650 million Healthy Opportunities Pilots program is the nation’s most expansive Medicaid program to address health-related social needs related to food, housing, transportation, and interpersonal safety and toxic stress.

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More Information:

Emerging Initiative - Expanding and Spreading State-Based Transformation in and Beyond North Carolina to Improve Health in the South

Project Page - Practical, Timely Lessons for Advancing and Aligning North Carolina's Health Care Transformation Leadership to Address Social Needs

Project Report - Addressing Social Needs through Medicaid: Lessons from Planning and Early Implementation of North Carolina’s Healthy Opportunities Pilots

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

Duke-Margolis, in partnership with the NC Department of Health and Human Services, the Health Care Payment Learning & Action Network, and the Centers for Medicare & Medicaid Services, convenes North Carolina’s State Transformation Collaborative, which is focused on multistakeholder alignment for value-based care, including performance measurement, data sharing, and health equity in an effort to strengthen coordinated and accountable primary care that improves well-being.

Read the full text here.

More Information:

Emerging Initiative - Expanding and Spreading State-Based Transformation in and Beyond North Carolina to Improve Health in the South

Project Page - North Carolina State Transformation Collaborative

Press Release - North Carolina Launches State Transformation Collaborative

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

More information coming soon.

Click here to learn more about Duke-Margolis work regarding Leveraging Opioid Settlements to Support Sustainable Community-Based Substance Use Disorder Treatment and Recovery Infrastructure: