NC Healthy Opportunities Pilot: Food as Medicine in Healthcare Spotlight

by Marissa Sheldon, MPH

What they do: The North Carolina Department of Health and Human Services (NCDHHS) has launched the Healthy Opportunities Pilot program (HOP), funded by the federal government, to test and evaluate the impact of providing non-medical interventions to high-needs Medicaid members. Service focus areas include food, housing and transportation, and toxic stress and interpersonal violence. 

Food services include:

  • SNAP enrollment assistance
  • Group nutrition classes
  • Diabetes prevention program
  • Produce prescriptions
  • Healthy food boxes and healthy meals (pick-up or home delivery)
  • Medically tailored meals (home delivery)

How they do it: Individuals who qualify for HOP services must be NC Medicaid Managed Care members living in one of the pilot region counties and have at least one qualifying physical or behavioral health condition and one qualifying social risk factor (ie. homelessness, food insecurity, or lack of transportation).

Care managers work with Medicaid members and all Medicaid Prepaid Health Plans to identify individuals who qualify and would benefit from HOP services and to track and manage individuals’ services over time. 

Each region has been assigned a Network Lead organization – Impact Health manages the Western NC region, Access East leads the Eastern NC region, and Community Care of the Lower Cape Fear oversees the Cape Fear region – that serves as the connection point between the health care and social services sectors. Network Leads are responsible for contracting with human service organizations (HSOs) in their region to provide services for all eligible Medicaid members, including pregnant women, children, and adults. HSOs for food services include food banks and pantries, nonprofits supporting farmers, food producers and retailers, and healthcare providers.  

Evaluation is a key component of the HOP program and is conducted by NCDHHS in collaboration with the University of North Carolina’s Cecil G. Sheps Center for Health Services Research. The evaluation includes measuring the effectiveness of non-medical interventions and the role of the Network Lead to improve health outcomes and reduce healthcare costs. Evaluation findings will be leveraged to incorporate similar interventions with Medicaid programs statewide. 

Mission: To establish and evaluate a systematic approach to integrating and financing evidence-based, non-medical services into the delivery of healthcare.

Major Funding: Federal government

Profit/nonprofit: N/A – government program

Budget: $650 million over 5 years

Interesting fact about how it is working to positively affect health: At the end of August 2023, more than 13,000 individuals had enrolled in HOP and 123,831 services had been provided. Enrollees have reported positive changes in their lives, including health improvements, financial relief, and overall enhanced quality of life. 


NC Department of Health and Human Services
Dorothea Dix Campus, Adams Building
101 Blair Drive
Raleigh, NC 27603

Core Programs: Healthy food delivery, produce prescriptions, nutrition classes

Number of staff: Unknown

Number of volunteers: Unknown

Areas served: Eastern and western North Carolina

Year Started: Funding awarded in 2018, services began in 2022.

Lead Evaluator: Seth Berkowitz, UNC Chapel Hill

Contact Information: 
Western NC HOP: Phone: 828-278-9900
Eastern NC HOP: 
Cape Fear HOP: | Phone: 1-800-953-0203 or 910-208-2024

Learn More:

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