A Message from NCTracks on Behalf of NC Medicaid New Study Shows Health Opportunities Pilots Reduce Costs and Improve Health Outcomes in North Carolina

The North Carolina Department of Health and Human Services (NCDHHS) is pleased to share new findings demonstrating the significant impact of the state’s Healthy Opportunities Pilots (HOP). According to a study conducted by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, HOP reduced total health care costs for NC Medicaid beneficiaries by an average of $164 per member per month. 

This comprehensive study, which evaluated more than 31,000 program participants enrolled between March 15, 2022, and November 30, 2024, found that HOP generated meaningful shifts in how people access care. Participants experienced fewer emergency department visits and hospitalizations and instead made greater use of cost‑effective outpatient services such as primary care. Importantly, the study also showed measurable decreases in food, housing, and transportation needs among participants. 

HOP is the nation’s first large‑scale initiative to evaluate how Medicaid funding can be used to deliver evidence‑based, non-medical services such as housing supports, food assistance, transportation and interpersonal safety service to improve health outcomes and reduce costs. The study confirms that the program led to lower overall spending, reduced barriers to health and well-being, and improved quality of life for North Carolinians. 

Monthly Medicaid savings in the study reflect the total cost of care, including medical services, HOP services and program operations. While costs increased early in program implementation, savings grew steadily over time. 

The Centers for Medicare & Medicaid Services (CMS) has authorized HOP to continue through December 2029. Although the program is primarily federally funded, the state is required to support a portion of the cost. The North Carolina General Assembly did not allocate additional state funding beyond July 1, 2025, resulting in a suspension of HOP operations. 

We appreciate your ongoing commitment to advancing health and well-being across our state. Should you have questions about the study or next steps related to the program, please feel free to contact