Feedback Opportunity for Healthy Opportunities Pilot Documents

DHHS released two important technical documents for stakeholder feedback related to the groundbreaking Healthy Opportunities Pilots that will be implemented within NC Medicaid Managed Care in early 2020. The two documents include:

 

Healthy Opportunities Pilots Service Definitions and Pricing Methodology

The pilots offer an unprecedented opportunity for North Carolina to systematically pay for nonmedical, evidence-based interventions designed to improve health and reduce costs, necessitating the development of a first-of-its-kind Medicaid fee schedule that is transparent, equitable and sustainable. The fee schedule will define and price pilot interventions based on a federally-approved list of services that address Medicaid enrollees’ housing instability, food insecurity, transportation insecurity, interpersonal violence and toxic stress.

 

DHHS seeks additional feedback from stakeholders on key components of the pilot service fee schedule, including:

  • Service Descriptions
  • Service Provider Descriptions
  • Service Payment Approaches and Pricing Inputs

 

Responses are welcome from all interested stakeholders. In particular, human services organizations, social service agencies and others that may seek to directly offer pilot services are strongly encouraged to provide feedback. Stakeholders are encouraged to use the standardized template found here to provide feedback by 5 p.m. on Aug. 2, 2019.

 

Healthy Opportunities Lead Pilot Entity Statement Of Interest and Supplementary Guidance

LPEs will serve as the essential connection between traditional healthcare and human service organizations. In their capacity as LPEs, selected organizations will not interact directly with pilot beneficiaries, but will play a crucial “behind the scenes” role by establishing a network of frontline human service providers to provide pilot services and connecting that network to Pre-Paid Health Plans. DHHS is developing a Request for Proposals (RFP) to procure two to four LPEs through a competitive bidding process. The department anticipates releasing the LPE RFP in fall 2019 and selecting LPEs in early 2020.

 

Organizations interested in bidding to serve as an LPE are encouraged to submit an SOI to bid.  Submission of an SOI is voluntary and non-binding and does not obligate an organization to submit a response to the LPE RFP. To promote collaboration among organizations interested in participating in the pilots, DHHS will post responses to the SOI on the Healthy Opportunities Pilots website in August 2019.

 

How to Submit an LPE Statement of Interest:

Potential LPE applicants are strongly encouraged to read the technical guidance on LPE roles and responsibilities prior to submitting an SOI. To submit an SOI, fill out the standardized form found here and send responses and any questions to healthyopportunities@dhhs.nc.gov by 5 p.m. on Aug. 12, 2019.

For more information on the Healthy Opportunities Pilots, please see the Healthy Opportunities Pilots Policy Paper, available here.

The Healthy Opportunities Team