Healthy Opportunities Pilot (HOP) Program

The opportunity for health begins where we live, learn, work and play.

North Carolina’s Healthy Opportunities Pilot program is an unprecedented opportunity to test the integration of evidence-based, non-medical interventions into the state’s Medicaid program. The Pilots will provide non-medical services to qualifying Medicaid members across four domains: housing, food, transportation and interpersonal violence/toxic stress. Critically, frontline care managers working in Pilot regions will play an essential role in identifying members that may benefit from Pilot services, recommending appropriate services and coordinating their care. Other staff working to support Pilot operations may find these trainings helpful to support their day-to-day work.

Keep this page open while you complete the steps below.

Step 1: Create an Account

· Create a MyAHEC account.
· Already have an account? Continue to Step 2.

Step 2: Register for Courses

· Select the registration link for the course listed in the table below. 
· Enter MyAHEC username and password and follow the prompts to complete registration.
· Register for each course individually by selecting the corresponding link.

Step 3: Access Course Materials

· Sign into MyAHEC.
· Select My Courses and Events.

· Select Access Course and Materials. 
· Select Open to launch a course.

Required and Recommended Trainings

Trainings will be continually added to this page as they are published.

REQUIRED TRAINING FOR CARE MANAGERS

TAILORED CARE MANAGERS
Release Date/Last UpdatedTitleSelect the link to register for your course or to view slides & recordings.Course is required for Care Mangers
October 20, 2023
 
Healthy Opportunities Pilot Training for PIHPs and Tailored Care Managers
Part 1
RegisterThis course is intended for Care Managers who will provide Tailored Care Management to Healthy Opportunities Pilot members.

November 20, 2023

Healthy Opportunities Pilot Training for PIHPs and Tailored Care Managers Part 2 RegisterThis course is intended for Care Managers who will provide Tailored Care Management to Healthy Opportunities Pilot members.
STANDARD PLAN CARE MANAGERS
Release Date/Last UpdatedTitleSelect the link to register for your course or to view slides & recordings.Course is required for Care Mangers
November 17, 2022
UPDATED October 2023
How Care Managers Can Choose Appropriate Interpersonal Violence ServicesRegisterYES

March 21, 2023
Healthy Opportunities Pilot: How Care Managers Can Choose Appropriate Interpersonal Violence Services Part 2RegisterYES

March 17, 2023How Care Managers
Can Obtain Pilot
Consent
RegisterAs Care Managers transition to using the consent form released in Spring 2023, this course is required.

N/A

NC AHEC Diversity, Equity, and Inclusion (DEI) for Primary Care Clinical Providers and Non-clinical Staff | Module 2 – Cultural HumilityMAHEC
YES

RECOMMENDED TRAINING FOR CARE MANAGERS

Release Date/Last UpdatedTitleSelect the link to register for your course or to view slides & recordings.Course is required for Care Mangers
October 23, 2024
Duplicative Medicaid and Healthy Opportunities Pilot ServicesRegister

August 7, 2024
10 a.m.
LIVE WEBINAR 
Supporting Survivors of Interpersonal Violence: Practice Session for HOP Care Managers Register

June 26, 2024 

Healthy Opportunities Pilot: Screening for Adverse Childhood Experiences for Care ManagersRegister

June 14, 2024 Healthy Opportunities Pilot Housing Rights 101: Tenant and Landlord ResponsibilitiesRegister

May 9, 2024 12:00-1:00pm Duplicative Medicaid and Healthy Opportunities Pilot Services – Live Webinar
Register

October 31, 2023 Intimate Partner Violence – Creating A Culture of Care for Survivors RegisterNote: HOP Care Managers can register for FREE, contact whitney.gordon@mahec.net for code. 

October 31, 2023 
Intimate Partner Violence – Best Practices in Intimate Partner ResponseRegisterNote: HOP Care Managers can register for FREE, contact whitney.gordon@mahec.net for code

January 20, 2023How Care Managers Can Choose Appropriate Health Related Legal SupportsRegister

December 27, 2022How Care Managers Can Choose Appropriate Toxic Stress ServicesRegister

December 8, 2022Understanding the Medical Respite Cross Domain ServiceRegister

September 20, 2022How Care Managers Can Choose Appropriate Housing ServicesRegister

September 2, 2022
How Care Managers Can Choose Appropriate Food Services within the Healthy Opportunities Pilot ProgramsRegister

September 2, 2022
UPDATED September 2023
How Care Managers Can Choose Appropriate Transportation Services, Version 2Register

August 22, 2022
UPDATED September 2023
Tracking Enrollee Progress, Reviewing Service Mix, and Reassessing Pilot EligibilityRegister

March 9, 2022

Assessing Member Eligibility for Participation in the Healthy Opportunities Pilots Recording and Slides

February 25, 2022Deeper Dive on Pilot Responsibilities of Frontline Care Managers Recording and Slides

February 11, 2022The Role of CIN Care Management Teams in the Healthy Opportunities PilotsRecording and Slides

N/AUsing Motivational Interviewing to Support the Healthy Opportunities PilotsSEAHEC

Training for Human Service Organizations (HSOs)

Release Date/Last UpdatedTitleSelect the link to register
for your course today
Required for HSOs
June 30, 2024

 
Healthy Opportunities Pilot Overview for Human Service OrganizationsRegister
March 17, 2023
Sensitive Services for
HSOs and Pilot Staff;
Privacy & Confidentiality
for Survivors
RegisterYES

Other HOP-related Trainings

Release Date/Last UpdatedTitleCourse materials
Recommended For
May 3, 2023




CHW Specialty Training Program: Introduction to Healthy Opportunities Pilots for CHWs
Register



Community Health Workers




May 16, 2022 Evidence Base Roundtable Series #6, Intimate Partner ViolenceSlides

May 12, 2022 Evidence Base Roundtable Series #5, Network Lead Pilot Region OverviewSlides

April 29, 2022  Evidence Base Roundtable Series #4 Housing, Transportation and Legal SupportSlides

April 21, 2022  Evidence Base Roundtable Series #3, Food and Pilots EvaluationSlides

April 12, 2022  Evidence Base Roundtable Series #2, SIRENSlides

April 6, 2022 Evidence Base Roundtable Series #1, KickoffSlides


February 15, 2023


Healthy Opportunities No Wrong Door Approach to EnrollmentRecording and SlidesPrimary Care Providers and Advanced Medical Homes

December 16, 2022


Healthy Opportunities Pilots:
Local Health Department Care Manager Pilot Engagement
SlidesLocal Health Departments





Building the skills and capacity for diversity, equity and inclusion (DEI) takes time to learn and integrate into patient care.  For this reason, it is recommended that Healthy Opportunities Pilot staff complete additional trainings, such as Implicit BiasStructural RacismCommunication in Healthcareand Microaggressions


Quality Improvement

Achieving Improvement and Sustainability

How can NC AHEC Practice Support help you?

NC AHEC provides Quality Improvement (QI) technical assistance at no cost to independent primary care and specialist practices, federally qualified health centers, rural health clinics, health departments and behavioral health providers in rural and under-resourced communities. 

While our primary focus is on quality care for Medicaid beneficiaries and Advanced Medical Homes, patients and clinical quality measures covered by any payer will benefit from our quality improvement work.  This includes the Medicare QPP/MIPS and Making Care Primary (MCP) programs, and value-based programs required by payors and CINs/ACOs.   Our services are focused on helping practices redesign their clinical and administrative workflows, optimize their teams and systems of care so that practices are able to thrive with value-based care.

If would like to connect with an NC AHEC practice support coach to assess your practice’s current state and improvement opportunities, please send your request to practicesupport@ncahec.net, and a coach will be in touch with you.

What is NC Medicaid’s Quality Strategy?

NC Medicaid’s Quality Strategy delineates an innovative, whole person, well-coordinated system of care that addresses both medical and non-medical drivers of health and promotes health equity. The Strategy:
• Focuses on rigorous outcome measurement compared to relevant targets and benchmarks,
• Promotes equity through reduction or elimination of health disparities, and
• Appropriately rewards health plans and, in turn, providers for advancing quality goals and health outcomes.

Did you know NC Medicaid and the Medicaid Health Plans support value-based purchasing arrangements? NC Medicaid requires the Medicaid health plans to offer Performance Incentive Payment opportunities to AMH Tier 3 practices and encourages the plans to offer incentive payments to practices in AMH Tiers 1 and 2. While performance thresholds and payment rates are set by Health Plans, all performance incentive payments must be based exclusively on the AMH measure set and not on measures outside of the set.

The Quality Strategy also supports Federal Regulation (42 CFR 438.330{d}) which requires Medicaid health plans to conduct performance improvement projects (PIPs) that: 
• Are designed to achieve significant improvement, sustained over time, in health outcomes and enrollee satisfaction.
• Include measurement of performance using objective quality indicators.
• Include implementation of interventions to achieve improvement in access to and quality of care.
• Include evaluation of the effectiveness of the interventions; and
• Include planning and initiation of activities for increasing or sustaining improvement

. . . . . . . . . . . . . . . . . . . . . . . .

The three NC Medicaid PIPs are:
• Childhood Immunization Status (Combination 10) for ages 0-2 years,
• Diabetes Management (A1C testing and results), and
• Timeliness of Prenatal and Postpartum care.


Statewide data from CY 2019 showed NC Medicaid was performing near or below the national Medicaid median on these PIP measures. NC Medicaid uses the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) measures to assess performance against benchmarks. Additionally, NC Medicaid noticed a need to improve data reliability and data capture for these areas.

See Quality Measurement Technical Specifications, North Carolina’s Medicaid Quality Measurement Technical Specifications Manual for Standard Plans and Behavioral Health Intellectual/Developmental Disability Tailored Plans for more details.

For the first two years of managed care implementation, NC Medicaid seeks a relative improvement of 5% over the prior year’s NC Medicaid statewide performance for each measure. Go to Quality and Population Health: AMH Measures, Statewide QI Projects to view baseline data and goals.

In support of NC Medicaid’s Quality Strategy and in collaboration with the health plans, NC AHEC (including its nine regional AHECs) applies its QI resources and strategies to support AMH practices and providers across the state as they work on the PIPs and other quality improvement initiatives. In addition, physicians and physician assistants may be able obtain MOC-IV credit if they work on a quality improvement project with an NC AHEC Practice Support coach.

In addition, NC AHEC helps small practices in North Carolina successfully participate in the Medicare Quality Payment Program (QPP), Merit-Based Incentive Program (MIPS), Value Pathways (MVP) and Making Care Primary Program (MCP).  This support is available at no cost to the practice.  More information can be found at www.qpp.cms.gov or reach out to your practice support coach at practicesupport@ncahec.net.


Statewide Projects

In addition to fulfilling the work owned by our six core service lines, our program also coordinates a number of designated statewide projects. These projects often cross service lines and our model to recruit, train, retain the health care workforce needed to create a healthy North Carolina. With goals and outcomes set by the Program Office and work led by regional AHECs, these initiatives touch on multiple areas of our mission statement. Click the buttons below to explore our most recent statewide work to help secure the health of North Carolinians in the months and years ahead. 

Every 10 years, North Carolina embarks on a goal setting process to identify the indicators or measures of good health and well-being for the people of our state over the next decade. Much of our statewide work aligns with the indicators identified in HNC 2030.

The NC AHEC Nursing Clinical Partner (CIP) program aims to increase nursing faculty through partnerships between academic nursing programs and practice organizations.

The NC AHEC Community Health Worker (CHW) Program supports the development of a qualified and sustainable CHW workforce well equipped to advance health equity.

Health equity means ensuring that every person in every community can get the same high-quality care. AHEC programming supports providers in delivering that high-quality care for all.

North Carolina’s Healthy Opportunities Pilot program is an unprecedented opportunity to test the integration of evidence-based, non-medical interventions into the state’s Medicaid program. The Pilots will provide non-medical services to qualifying Medicaid members across four domains: housing, food, transportation and interpersonal violence/toxic stress.

Healthy North Carolina 2030

What is Healthy North Carolina 2030 and the NC State Health Improvement Plan?

Every 10 years, the state of North Carolina embarks on a goal setting process to identify the indicators or measures of good health and well-being for the people of our state over the next decade. The culmination of this process for the current decade, led by the North Carolina Institute of Medicine (NCIOM) and Department of Health and Human Services (DHHS) is known as Healthy North Carolina 2030 (HNC 2030). These indicators were selected based on evidence of impact on health and with input from over 400 experts and community members. In developing HNC 2030, the team recognized the important roles of health behavior, social and economic factors, and the physical environment in contributing to health care. HNC 2030 serves as the foundation for the North Carolina State Health Improvement Plan (NC SHIP). 

What is the role of NC AHEC?

NC AHEC is a key partner for NC SHIP implementation.  Through programming designed to contribute to a healthier NC, much of our statewide work aligns with the indicators identified in HNC 2030.  

Our programming:

  • Supports the improvement of statewide Behavioral Health outcomes through educational training and practice support.  
  • Delivers educational programming to address substance abuse issues through Opioid Screening, Buprenorphine training and Tobacco and Alcohol use treatment/education. 
  • Helps primary care practices close care gaps with adult diabetes screening rates, pediatric immunizations and timely access to prenatal care at no cost.
  • Supports medical residency training programs, aiming to increase residency positions in rural areas as a means of decreasing health inequities. This is done via programmatic and financial assistance.
  • Provides educational courses addressing the community health disparities outlined in NC SHIP, delivering the training needed to keep NC’s providers current within emerging public health issues. 

This brief video, featuring Dr. Adam Zolotor, NC AHEC Associate Director for Medical Education and former President and CEO of the NCIOM, provides a high-level overview of HNC 2030 and its impact on the health of individuals in North Carolina. 

Where can I get more information at one of our Regional AHEC Centers?

Please view this directory to find the contact at your Regional AHEC for each HNC2030 indicator that aligns with our statewide work. We have designated contacts for indicators 5, 10-15, and 17-19.

Health Equity

NC AHEC Diversity, Equity, and Inclusion (DEI) Modules for Primary Care Clinical and Non-clinical Staff

In order to ensure high-quality care, health care providers are required to be competent not only in medicine but also in communication and caring for people with different disease burdens, socio-cultural realities, expectations, values, and beliefs. Be it the result of a language barrier, differences in philosophy, differences in cultural norms (and expectations), or even cultural bias, a lack of understanding can lead to communication breakdown with patients. Consequently, when patients cannot fully communicate or express their needs, health inequities and health disparities occur.

Health equity means ensuring that every person in every community can get the same high-quality care. A number of social, economic and cultural factors significantly affect both physical and mental health. Health care providers benefit from education to recognize and eliminate these disadvantages that lead to health care disparities through initiatives that increase diversity in leadership, improve training for cultural humility, and strengthen community partnerships.

The program consists of 11 individual modules and will focus on implementing strategies of health equity that are proven to improve patient care including:
• Articulating how health equity plays a heightened and essential role in today’s healthcare environment
• Educating clinical providers and non-clinical staff on fundamental concepts to assist providers and staff to increase knowledge and adopt equitable practices  
• Integrating values and core principles into the patient care environment
• Building core competency and shared language across staff