Slow start for huge new NC health program after 3 years and $27 million

State health officials have high hopes for a new $650 million, one-of-a-kind pilot project to help people stay healthy by using state and federal Medicaid money to pay for healthy food, transportation to the gym, housing and counseling.

Three-and-a-half years after the federal government signed off on the idea, the first part of the program got underway last month, with 10 people receiving healthy fruits and vegetables.

The state Department of Health and Human Services announced this as a major milestone. The total cost so far is $27 million, much of which went toward infrastructure the department plans to use for years to come.

“We purposefully started small,” said Dave Richard, who heads the Medicaid program for Gov. Roy Cooper’s administration. “We want to make sure that our systems are working, that we can do the kind of referrals that are so critical in this.”

Richard said he hopes to be helping 13,000 people a month by the summer of 2023. The food program started last month. Housing and transportation services are scheduled to go live in May. And, starting mid-June, DHHS hopes to have services up and running for victims of domestic and other forms of interpersonal violence.

Then there was a pandemic.

Spending so far on the pilot has “mostly been capacity building,” Richard said, making sure partners can share data and that small community organizations involved can bill Medicaid—a complicated task many of them had never attempted.

“We have, obviously, a great deal of accountability for federal dollars … and our state dollars,” Richard said. “We have a lot of rules and regulations.”

The plan is to track health impacts. When a patient who’s been getting healthy food housing assistance through the program goes to the doctor, is their blood pressure better? Is their cholesterol lower, or their weight?

“We might find things that we’re proposing that don’t work,” Richard said. “What [the federal government] is going to want to know is, at the end of the day, are those people actually healthier?”

If people get healthier, the project could be replicated nationwide. Right now North Carolina is the only state in the country authorized to spend Medicaid money in this way, Richard said, and the pilot is only running in three regions of the state, mostly lower-income counties either in the mountains or Eastern North Carolina.

The plan has bipartisan support, with the federal Centers for Medicare & Medicaid Services signing off on the proposal from Cooper’s DHHS during President Donald Trump’s administration. The program was approved to run from Nov. 1, 2019, through Oct. 31, 2024. The maximum spend is $650 million, but Richard said last week that the state may not spend all that money.

Three groups are acting as network leads on the project, one for each region: Access East and Community Care of the Lower Cape Fear in eastern North Carolina and Dogwood Health Trust in the west. Leaders for those groups either didn’t return WRAL News messages seeking comment or said they weren’t available for an interview.