Healthcare programs that address social determinants of health—such as nutrition, housing, and transportation—can achieve better health outcomes while reducing overall healthcare costs. The Healthy Opportunities Pilot in North Carolina demonstrated this by using Medicaid funds to provide food boxes, housing assistance, and other basic needs to vulnerable populations, resulting in significant reductions in emergency room visits and hospitalizations, with cost savings of approximately $1,000 per member per year.
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The Root of Good HealthAdded:
I have lived in Hendersonville for about 20 years.
I was just driving here and I saw the mountains and it was the first time that I fell in love with something that wasn't a person.
I get to work with an organization called Cajasol Adaria.
Our mission is to ensure that everybody has access to the abundancia of our beautiful Southern Mountains.
We started as a produce buying club during the pandemic because there was a shortage of food in our grocery stores.
I was volunteering at Cajasol when we heard about the Healthy Opportunities pilot.
Healthy Opportunities is one of the most innovative ways that we can spend healthcare dollars. So, the goal wasn't necessarily to just reduce spending. It was to spend the dollars better.
In North Carolina, our General Assembly was really trying to understand how we could reduce the cost of the Medicaid spend and get better health outcomes.
In order to access the program, an individual had to have access to Medicaid managed care. Adults had to have at least two chronic conditions that could be improved with access to services and children had to have at least one.
Most of your health outcomes are decided before you ever get to see a doctor.
What people are eating, whether they have a safe place to lay their head, if they have transportation to get to the things they need, that's how we define health in North Carolina.
>> [music] >> I'm a single mother.
When we heard about the Healthy Opportunities [music] pilot, I was living in public housing.
We were on Medicaid.
My son was having gastrointestinal [music] issues.
I took him to the doctor and he was prescribed prescription >> [music] >> food box.
Back here is our food is medicine grocery shopping.
All of it is organic.
>> [music] >> All of it is as local and seasonal as possible.
And I am going to take what I think my [music] family is going to eat for the week.
When the Healthy Opportunities [music] pilot was in service, people got to come grocery shopping here for free and they'd be able to take [music] one or more baskets home with them.
When we received the boxes, my son did not need medicine >> [music] >> to alleviate his symptoms.
It was very empowering for me personally because it [music] made me feel like I can provide for my family.
Being employed at Cajasol, we are no longer on Medicaid. I bought a house by myself. [music] It was the Healthy Opportunities pilot and Cajasol that it has allowed this to happen [music] for my family.
At the time of the Healthy Opportunities [music] launch, we started with like 45 participants and then within two years, we got up to serving 450 families.
Within [music] our last year of operations, we were able to invest $2.5 million within our local economy and that was through supporting local farmers, local businesses.
>> [music] >> It was a family-owned farm since the late 1800s.
In 2022, we started cleaning up the property with the intention of becoming regenerative [music] and organic farmers.
One day, we met the ladies from Cajasol Adaria.
>> [music] >> We were growing as much as we can, providing as much eggs as we could and they were buying every product that we could produce.
It encouraged me to go lease another farm.
Over 400 farms were involved in selling into this program.
We've seen over 900 jobs created. Thank you so much. You're welcome. It's my pleasure.
We cultivated intentional relationships and connections with people in the community.
I am saying, "Hello, how's it going?
Let's see what resources we have to try to get your needs met."
>> [laughter] >> Housing has a huge impact on health and so stabilizing housing is a really important part of how Healthy Opportunities works.
We had mold in the house and my grandson had autoimmune things and lung issues.
We were both [music] sick all the time.
I remember calling someone and saying, [music] "Listen, I have mold in my house.
Is there anything y'all can do about [music] it?"
They said, "Well, HOP will take care of it.
We have funds that can help you."
The mold was so bad on this side of the house, they had to gut the bathroom and almost and start all over. It was in the walls, it was in the floor.
That network was developed from HOP.
Some of the people I don't even know, but they all stepped up and just took care of it.
It's really about meeting a person as a whole person, not as a diagnosis, not as a social need. We want to make sure that our clinical spend is focused on what it needs to be, not what could have been prevented if we invested earlier and in better ways.
We were optimistic that we would see some positive movement in that first 18 months, but we were blown away by what we really saw.
Huge drops in emergency room visits and in hospitalizations.
Initially, the spend goes up, but they showed the cost curve bends down and ultimately you could see a cost savings about $1,000 per member per year.
So, to see this, it's a huge potential for us to really shift the way that healthcare dollars are spent in the country.
We were notified we would have to stop services by the end of June.
>> [music] >> So, our initial heartache was for our families that were losing access to services with very little notice.
The Healthy Opportunities [music] pilot was meeting people's basic needs.
The needs that we have in order to not even thrive, but just to survive.
We had to lay off seven staff [music] members.
It's a really big loss to the community.
It's the farmers and the organizations.
Like there are so many people involved in [music] making the Healthy Opportunities pilot happen.
Unfortunately, when we heard that the Healthy Opportunities program was going to end, I had to put the brakes on.
>> [music] >> Now I have to have our workers work less hours.
We've had to lay two people off.
How do small farmers continue to exist when it's such a challenge to be profitable?
Healthy Opportunities gives us the greatest chance of making sure that folks are fully supported until they can get to that next step.
It's a hand up, not a handout.
This program shows how much we care about each other and that's [music] a really important part of a thriving community. Not just that individuals have what they need, but they live in a community that sees [music] each other and is committed to caring for and lifting each other up.
>> [music] >> Investing in these other drivers of health can get us to a better place.
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