Advisory Panel for the North Carolina Healthy Opportunities Pilot Service Fee Schedule

General Information

The Commonwealth Fund and Manatt Health convened an expert advisory panel to offer feedback on a groundbreaking effort of the North Carolina Department of Health and Human Services (NC DHHS). Under its recently approved Medicaid 1115 waiver, NC DHHS will launch “Healthy Opportunities Pilots” in up to three geographic areas of the state to test nonmedical, evidence-based interventions designed to improve health and reduce costs for a subset of Medicaid beneficiaries. Pursuant to waiver requirements, NC DHHS developed a first-of-its-kind Medicaid fee schedule that defines and prices Pilot interventions, which address housing instability, food insecurity, transportation insecurity, interpersonal violence and toxic stress. The Pilot Service Fee Schedule was approved by the Centers for Medicare & Medicaid Services (CMS), and is available here. The Commonwealth Fund posted a blog about the wide-ranging impact of the fee schedule.

NC DHHS sought a broad range of stakeholder input to inform the development of the Pilot Services Fee Schedule. The Department released a Request for Information in February 2019 and draft Pilot Service Definitions, Pricing Methodology, and Pricing Inputs in July 2019 receiving invaluable feedback from stakeholders. The purpose of the advisory panel was to leverage the experience of a diverse group of national and local experts to discuss the methodology and assumptions for developing the Fee Schedule, offer recommendations for strengthening North Carolina’s approach, and provide feedback on draft Fee Schedules in advance of CMS submission.

The panel convened in the spring and summer of 2019. The advisory panel meetings, which were held in Raleigh, North Carolina, were open to the public. The floor was open for questions and comments from public attendees at the end of each meeting. Meeting materials are posted on this website.

Please see below for the CMS-approved Pilot Service Fee Schedule, panel members, meeting dates and locations, meeting materials, and more information about the Healthy Opportunities Pilots. All interested stakeholders are invited to join the Department’s Healthy Opportunities listserv to receive programmatic updates regarding the Pilots and other DHHS Healthy Opportunities initiatives.

The CMS-approved Pilot Service Fee Schedule was published in North Carolina’s Lead Pilot Entity Request for Proposal Addendum #7 (pp. 24-68). An excerpted version is available here.

Name Title
Arlene Ash Professor of Quantitative Health Sciences, University of Massachusetts Medical School
Emily Carmody Program Director, North Carolina Coalition to End Homelessness
Dr. Alisahah Cole Chief Community Impact Officer, Atrium Health
Dr. Chris Esguerra Senior Medical Director, Blue Shield of California
Robert Feikema President and CEO, Family Services
Kristin Giantris Managing Director of Consulting, Nonprofit Finance Fund
Michael Griffin President and CEO, Daughters of Charity Services of New Orleans
Tiana Joyner Vice President, Volunteers of America Carolinas
Dr. Mark McClellan Director, Duke Margolis Center for Health Policy
Len Nichols Director of the Center for Health Policy Research and Ethics and Professor of Health Policy, George Mason University
Ross Owen Health Strategy Director, Hennepin County
Regina Petteway Director, Wake County Human Services
Kim Schwartz CEO, Roanoke Chowan Community Health Center
Glenn Wise Director of Programs, MANNA Food Bank

Advisory Panel Meeting: Reviewing Draft Pilot Service Definitions

Advisory Panel Meeting: Reviewing Draft Pilot Service Pricing Inputs and Methodology

For more information about the Healthy Opportunities Pilots, please reference the following materials:

Additionally, sign up for NC DHHS’s Healthy Opportunities listserv to receive updates about Healthy Opportunities initiatives by emailing healthyopportunities@dhhs.nc.gov.

Co-Conveners
 

Manatt Health:

Melinda J. Dutton

Partner

Email | Bio

Melinda Dutton, partner at Manatt Health, serves as the primary point of contact for this initiative. At Manatt, Melinda helps clients navigate the legal, regulatory and political challenges of healthcare reform and programs such as Medicaid and the Children’s Health Insurance Program. For more than 25 years, her work has focused on improving the health and well-being of low-income and vulnerable populations, including work at the Children’s Defense Fund and for a community legal services organization prior to joining Manatt. With her robust experience with Medicaid, CHIP, the Affordable Care Act, marketplaces, the healthcare safety net and payment reform, healthcare transformation is a significant focus of Melinda’s practice. She currently serves as an advisor to the NC DHHS on its Medicaid transformation efforts.

The Commonwealth Fund:

Melinda K. Abrams

Vice President, Delivery System Reform

Email

Melinda K. Abrams, M.S. is vice president and director of The Commonwealth Fund’s Health Care Delivery System Reform program. Since coming to the Fund in 1997, Melinda has worked on the Fund’s Task Force on Academic Health Centers and the Child Development and Preventive Care program, and most recently, she led the Patient-Centered Coordinated Care Program. Melinda has served on many national committees and boards for private organizations and federal agencies, and is a peer reviewer for several journals. She was the recipient of a Champion Award from the Primary Care Development Corporation and a Primary Care Community/Research Leadership Award from the Patient-Centered Primary Care Collaborative. Melinda holds a B.A. in history from Cornell University and an M.S. in health policy and management from the Harvard School of Public Health.

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