North Carolina Ends Medicaid HRSN Pilots Despite Savings & Fewer ED Visits

On July 1, 2025, the North Carolina Department of Health and Human Services (NCDHHS) ended the Healthy Opportunities Pilots (HOP), which was enabled using Medicaid funds to pay for non-medical health related social needs (HRSNs). NCDHHS had been planning to expand the program statewide as late as March 2025 but the state’s General Assembly did not include funding for state fiscal years 2026 and 2027.

A program evaluation found that HOP participation reduced spending on medical and HOP services by $85 per member per month relative to expected medical spending in the absence of the HOP services. HOP . . .