Throughout its transformation efforts, NC Medicaid built a population health approach to improve the health of all North Carolinians through an innovative, whole-person centered, and well-coordinated system of care that addresses both the medical and non-medical drivers of health and considers members’ unique needs.
Most North Carolinians enrolled in Medicaid today receive health coverage through managed care plans, which provide a robust set of integrated services, including physical health, behavioral health, long term services and supports, pharmacy benefits and connection to non-medical services that improve health. The transition to managed care is a springboard for whole-person centered care in North Carolina that allows NC Medicaid to test and scale the state’s population health approach to improve the outcomes and experience of Medicaid enrollees.
As NC Medicaid moves ahead with its managed care system, it is focused on re-affirming efforts to improve member outcomes, ensuring continued provider participation in the Medicaid program to maintain access to high-value care, and updating population health initiatives to best serve members and advance their health.
NC Medicaid has released Improving Health and Promoting Value: An Update on the Population Health Approach Guiding North Carolina’s Medicaid Transformation, which describes the purpose and progress of four foundational population health strategies in NC Medicaid’s transformation:
- Strategy 1: Reinforcing and Strengthening Primary Care
- Strategy 2: Investing in Community-Based Care Management
- Strategy 3: Identifying and Addressing Non-Medical Drivers of Health
- Strategy 4: Using Data to Design Evidence-Based Programs
These strategies are interdependent—each advancing a shared set of aims and together helping Medicaid members receive the right care, in the right setting, and at the right time for each individual member while improving overall population health. The policy paper outlines the goals of each strategy and key initiatives to advance those goals; achievements and lessons learned to date; and planned next steps to work with community partners to realize a healthier North Carolina.
Community partners are encouraged to provide feedback on this paper by emailing Medicaid.NCEngagement@dhhs.nc.gov (subject line “Improving Health and Promoting Value: An Update on the Population Health Approach”) by May 30, 2025.