What we know: Because the health care system is undergoing a sweeping shift driven by rising costs, poor outcomes, and federal reform, it is moving from traditional reimbursement methods to a concept called value-based care. Value-based care is meant to encourage population health improvement and keep people out of the hospital. In 2021, the state launched Medicaid managed care–the largest experiment implementing value-based care in NC–resulting in approximately 1.7 million people experiencing a change to their insurance.

What we do: We work to ensure that this change narrows racial disparities in health outcomes and improves the health of people whom the system has too often overlooked. We know the power is in community. Urban Institute research shows that the shift to Medicaid managed care has been confusing for beneficiaries, specifically around selecting health plans, finding providers, and accessing services. The Trust is funding advocacy efforts to try to increase direct connections to impacted residents.

What we know: As the health system shifts to new payment models, we know that financially vulnerable residents, including the uninsured and underinsured, will suffer disproportionately from a lack of access to care. Given this transition and the COVID-19 pandemic, it is especially important to ensure the continued viability of the state’s health care safety net system.

What we do: During the implementation of value-based care in North Carolina, we are focused on ensuring safety net providers, including federally qualified health centers, free and charitable clinics, rural health centers, and public health departments, have the capacity to pivot with new payment systems. We also invested in the North Carolina Institute of Medicine’s Task Force on the Future of Local Public Health to better understand how our public health system can be strengthened moving forward.