The state’s Healthy Opportunities Pilot is seen as a national model for integrating social care, reducing costs, and strengthening trust across communities.
Pictured, L-R, Rick Whitted, Brandon Wilson, Dr. Laurie Stradley, and Kody Kinsley
Health leaders from North Carolina described sweeping transformations underway in Medicaid, highlighting how the state’s innovative Healthy Opportunities Pilot is reshaping care delivery by reimbursing social services, reinforcing local nonprofits, and driving measurable cost savings.
Moderated by Rick Whitted, CEO of U.S. Hunger, the 50‑minute panel at last week’s RISE Healthy Communities Summit featured Kody Kinsley, former North Carolina secretary of Health and Human services; Dr. Laurie Stradley, CEO of Impact Health; and Brandon Wilson, COO of Asheville Buncombe Community Christian Ministry (ABCCM). They offered insight into how one of the nation’s most ambitious social‑care‑integration experiments is unfolding in real time.
Financial support for social drivers
As part of the pilot program, North Carolina aims to ensure health care dollars are spent effectively by focusing on “buying health,” not just health care.
Kinsley emphasized that true impact lies in supporting foundational drivers such as food, transportation, and safe housing not merely clinical services. By combining managed care reform with North Carolina’s 1115 waiver, the state embedded social care directly into Medicaid contracts.
Early results are striking: “We found that for the folks we were engaging with [we were] saving $85 per person per month… in healthcare dollars that’s real big money.”
Kinsley said that updated analyses may reveal even greater savings.
For frontline nonprofits, the pilot is transformative. Wilson, whose organization runs food distribution, housing, crisis services, and a free medical clinic, described the pilot as a long-needed shift: “The idea of us being able to finally actually get paid for services that we’ve been doing since 1969 was very exciting for us,” he said.
The program reimburses community organizations for delivering food boxes, transportation, home repairs, and other supports previously dependent on charitable dollars. That financial predictability, he said, strengthens the entire social safety net:
“No one organization can do it by themselves… we were able to help other smaller community-based organizations actually come up and get stronger because we’re all stronger together.”
A connected ecosystem ends fragmented help
Dr. Stradley, leading one of the regional care hubs, emphasized the importance of infrastructure, interoperability, and trust.
Impact Health acts as a bridge between clinical care and more than 60 nonprofits across Western North Carolina and ensures compliance, payment, quality, and data sharing. “We didn’t want our community partners to have to become a Medicaid provider. We wanted them to keep focused on what they already do so well… We wanted to be there for them.”
She stressed that the shift is operational and cultural: “We trusted our community and they came through.” The panelists agreed the result is a stronger, more coordinated community safety net—one that reduces duplication and ensures people no longer fall through the cracks.
A recurring theme of the discussion was how data combined with lived experience improves outcomes. Stradley noted that real-time assessments combined with the statewide NC Care 360 closed-loop referral system enable tailored, coordinated care at population and individual levels. But she also underscored that data alone is insufficient. The most valuable insights often start with frontline staff. For example, a volunteer who delivered a food box reported that a client was unable to get out because her ankles were swollen. A case manager was then able to reach out to her and address her needs.
Future innovation plans
Looking ahead, North Carolina is applying for grants to try and use lessons from the pilot to extend the hub model to up to six regions statewide and connect existing systems in a more cohesive strategy: “It’s keeping the work close to community… but applied more broadly to health care.”
The stakes are enormous: the state faces an estimated $30–$50 billion reduction in Medicaid investment over 10 years.