Background

Because the health care system is undergoing a sweeping shift driven by rising costs, poor outcomes, and federal reform, it is moving away from traditional reimbursement methods built on individual payments for each medical service, to a concept called value-based care. Value-based care is meant to encourage population health improvement and keep people out of the hospital.

The movement toward value-based care takes many forms in North Carolina. Networks called Accountable Care Organizations work to integrate groups of doctors, hospitals, and other health care providers to deliver high quality, coordinated care to a defined patient population such as Medicare recipients. Attempts to transform the health system also are reaching into neighborhoods to coordinate clinical care with social services and community-based organizations. This model is referred to as Accountable Care Communities. Accountable Care Communities aim to address some of the underlying drivers of poor health outcomes such as food insecurity, substandard housing, inadequate transportation, and interpersonal violence.

One of the Trust’s overarching goals is to achieve equitable health outcomes. During the implementation of value-based care over the next several years, we want to ensure that populations traditionally suffering the worst health outcomes, especially people with low incomes and racial minorities, are directly engaged in reform efforts and have an equitable opportunity to enjoy improved health and well-being.

The largest experiment implementing value-based care in North Carolina that most impacts low-income communities is the remaking of the state’s Medicaid program. Medicaid is a joint state and federal program that pays for the care of approximately 2 million North Carolinians, or about 20 percent of the state’s population. Most Medicaid recipients are children, pregnant women, seniors, and people with disabilities. Value-based care and Medicaid reform hold the promise to provide better care at lower costs. But a change of this size and scale also can reproduce or exacerbate the deficiencies and disparities of the current structure.

Opportunity Details

The Trust is primarily interested in hearing from applicants that are assisting with the planning and design of the state healthy opportunity pilots in Medicaid. We also will consider projects that build the infrastructure to help the Medicaid pilots successfully serve financially disadvantaged residents. The Trust may support a limited number of other innovative ideas for utilizing value-based care to achieve more equitable health outcomes.

Future Funding Opportunities

As Medicaid reform and value-based care take shape in North Carolina, the Trust envisions opening future opportunities. Please visit the grantmaking section on our website over the coming year, as we continue to build a strategy that’s informed by changes in our state’s health system. If you have ideas or expertise to offer about approaches that leverage value-based care to achieve equitable health outcomes for financially disadvantaged North Carolinians, please contact us so that we can collect information for potential partnerships and funding announcements.

Related Funding Opportunities

The Trust is also interested in public education efforts to ensure local groups including nonprofits, safety net providers, and marginalized populations understand and can engage in the state’s transition to value-based care. View the current public education funding opportunity here.