Healthy Opportunities Pilots interim evaluation report

North Carolina’s Section 1115 Medicaid Demonstration Waiver entitled “North Carolina Medicaid Reform” was approved to cover the period November 1, 2019 through October 31, 2024. One aspect of that Demonstration Waiver is the State of North Carolina’s Enhanced Case Management and Other Services Pilot (ECM), more commonly referred to as the Healthy Opportunities Pilots (abbreviated as the ‘Pilots’ or ‘HOP’). Owing to the national context of the COVID-19 pandemic and local context, such as the delay in transition to Medicaid-managed care, the Pilots did not begin providing services until March 15, 2022. Thus, the Pilots have been actively delivering services for less time than intended. The purpose of this Interim Evaluation Report is to assess the impact of the Pilots to date and to provide information to guide continued service delivery and programmatic adjustments for the Pilots. This assessment includes data regarding the delivery of pilot services from March 15, 2022 to November 30, 2023. This report is specific to the Pilots and does not cover other elements of the 1115 Waiver, which have been submitted as a separate Interim Evaluation Report. It also only includes ‘standard’ Pilot services and does not include the separate, direct-to-consumer ‘expedited enrollment’ program launched on March 21, 2023. Data from the ‘expedited enrollment’ program are not included in this report both given its relatively short time of operation in this evaluation period and limitations in data available to evaluate the program, which does not use the same data systems as the ‘standard’ Pilots. Analyses of the direct-to-consumer program will be included in the summative evaluation. Finally, this evaluation report is not meant to be as comprehensive as the subsequent summative evaluation.