{"id":2404,"date":"2022-10-25T12:47:47","date_gmt":"2022-10-25T16:47:47","guid":{"rendered":"https:\/\/unite-us-tailwind.local\/?p=2404"},"modified":"2024-06-21T11:51:27","modified_gmt":"2024-06-21T15:51:27","slug":"north-carolina-hop-healthy-opportunities-pilot","status":"publish","type":"post","link":"https:\/\/uniteus.com\/blog\/north-carolina-hop-healthy-opportunities-pilot\/","title":{"rendered":"How North Carolina is Improving Lives Through the Healthy Opportunities Pilot"},"content":{"rendered":"<p><a href=\"https:\/\/www.ncdhhs.gov\/about\/department-initiatives\/healthy-opportunities\/healthy-opportunities-pilots\"><span style=\"font-weight: 400;\">The Healthy Opportunities Pilot<\/span><\/a><span style=\"font-weight: 400;\"> (HOP) is the nation\u2019s first comprehensive program to provide evidence-based interventions\u2014including housing, food, transportation, interpersonal safety, and toxic stress support services\u2014to high-needs <a href=\"https:\/\/uniteus.com\/solutions\/health-plans\/\">Medicaid enrollees<\/a>. Through an 1115 waiver, the federal government has authorized up to $650 million in Medicaid funding to reimburse providers in North Carolina for these non-medical interventions over five years. This program will ensure that Medicaid members have timely access to critical social care services to improve their health.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unite Us is proud to serve as the technology backbone connecting health plans, network leads, providers, and public entities engaged in HOP. With Unite Us\u2019 Social Care Payments product, providers can manage eligibility and authorization, send referrals to contracted providers, securely track outcomes and document services, generate invoices, and efficiently manage reimbursement of social care services.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In record time, <\/span><span style=\"font-weight: 400;\">Unite Us successfully socialized the new program and trained, onboarded, and enabled five prepaid health plans, three network leads, three clinically-integrated networks, and more than 100 health service organizations.<\/span><\/p>\n<h2>HOP is Expanding Social Care to North Carolinians<\/h2>\n<p><span style=\"font-weight: 400;\">In the first few months since HOP launched in March 2022, community-based organizations have provided nearly <\/span><b>10,000 <\/b><span style=\"font-weight: 400;\">social care services that are\u2014for the first time in the nation\u2014eligible for Medicaid reimbursement. In that same time, North Carolinians have received more than<\/span><b> 5,000<\/b><span style=\"font-weight: 400;\"> food boxes addressing needs like food insecurity and many others.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To date, 97 percent of individuals identified by a care manager as eligible for the pilot were successfully enrolled in the program. After a service is approved through the CMS-mandated workflow, providers accept the referral to provide services within one day on average. And the rejection rate for claims is less than 3%, compared to typical clinical rejection rates of 10-20%, which reflects the high-quality eligibility and invoicing process facilitated by Unite Us and its partners in North Carolina.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unite Us has a long history of proven success in North Carolina dating back to 2015. Following the success of the competitively procured, statewide <a href=\"https:\/\/uniteus.com\/solutions\/health-plans\/\">care coordination<\/a> network in North Carolina powered by Unite Us\u2014known as <\/span><a href=\"https:\/\/nccare360.org\/\"><span style=\"font-weight: 400;\">NCCARE360<\/span><\/a><span style=\"font-weight: 400;\">\u2014the state made the decision to work with Unite Us to launch the Healthy Opportunities Pilot in 2022 to reduce silos, improve efficiency, and reduce overall spend.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unite Us is extremely proud of our work supporting communities across North Carolina, the success of which has been recognized throughout the country, including by the<\/span><a href=\"https:\/\/nciom.org\/lessons-learned-thus-far-from-north-carolinas-healthy-opportunities-pilots\/\"> <span style=\"font-weight: 400;\">North Carolina Institute of Medicine<\/span><span style=\"font-weight: 400;\">;<\/span><\/a> <a href=\"https:\/\/www.healthleadersmedia.com\/payer\/how-north-carolina-implementing-multi-faceted-sdoh-transformation\"><span style=\"font-weight: 400;\">Health Leaders<\/span><\/a><span style=\"font-weight: 400;\">; the<\/span><a href=\"https:\/\/www.americanprogress.org\/article\/how-north-carolina-is-using-medicaid-to-address-social-determinants-of-health\/\"> <span style=\"font-weight: 400;\">Center for American Progress<\/span><\/a><span style=\"font-weight: 400;\">;<\/span><a href=\"https:\/\/issuu.com\/woodrowwilsonschool\/docs\/aca_report_final_3-20-2022\"> <span style=\"font-weight: 400;\">Princeton School of Public and International Affairs<\/span><\/a><span style=\"font-weight: 400;\">; and<\/span><a href=\"https:\/\/www.politico.com\/agenda\/story\/2019\/10\/24\/north-carolina-health-care-001291\/\"> <span style=\"font-weight: 400;\">Politico<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p style=\"text-align: center;\"><a class=\"button button-solid\" href=\"https:\/\/nccare360.org\/\">Learn More<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Healthy Opportunities Pilot (HOP) is the nation\u2019s first comprehensive program to provide evidence-based interventions\u2014including housing, food, transportation, interpersonal safety, and toxic stress support services\u2014to high-needs Medicaid enrollees. Through an 1115 waiver, the federal government has authorized up to $650 million in Medicaid funding to reimburse providers in North Carolina for these non-medical interventions over&#8230;<\/p>\n","protected":false},"author":6,"featured_media":2405,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[1],"states":[37],"topic":[80],"industry":[97],"series_name":[],"class_list":["post-2404","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","states-north-carolina","topic-whole-person-health","industry-all"],"acf":{"layout":"default","gated_page":{"":null,"title":"","featured_image":null,"description":"","form_title":"Fill out the form to download the white paper.","code_editor":"","title_2":"","description_2":"","embeds":null,"display_cta_button":true,"button_text":"Download the White Paper"},"columns":null,"download_page":{"document":""},"reports_component":{"components":null},"webinar_components":{"components":null,"speakers":{"speaker_heading":"Speakers","all_speakers":null},"organizations":{"organization_heading":"Organizations","all_organizations":null}}},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Improving Lives Through the Healthy Opportunities Pilot<\/title>\n<meta name=\"description\" content=\"In North Carolina, the Healthy Opportunities Pilot is providing housing, food, transportation, interpersonal safety, and more to high-needs Medicaid enrollees.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/uniteus.com\/blog\/north-carolina-hop-healthy-opportunities-pilot\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta 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