Medicaid Spending and Health-Related Social Needs in the North Carolina Healthy Opportunities Pilots Program

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Medicaid spending increased at the time of HOP enrollment but decreased over time, leading to lower overall spending.

Provided evidence that addressing health-related social needs through nonmedical services can lead to improved health outcomes and reduced healthcare costs.

Summary of Conclusion/Findings

The study evaluated the North Carolina Healthy Opportunities Pilots (HOP) program, which provides nonmedical services to address health-related social needs, such as healthy food boxes and housing navigation, financed by Medicaid. The study found that while Medicaid spending increased at the time of HOP enrollment, there was a significantly decreasing trend in spending over time compared to a scenario without the program. By month eight, spending was equivalent to what would have been expected without HOP and lower thereafter. The program also led to a reduction in emergency department visits but did not significantly impact hospitalizations or outpatient visits. These findings suggest that addressing health-related social needs can improve health outcomes and reduce healthcare costs for Medicaid beneficiaries.