Focus Area: Healthcare Access & Equity

Overview

The things that make Western North Carolina special - the sweeping mountain vistas, vibrant mountain culture and towns, and strongly-held attitudes of independence and self-sufficiency within its communities - can also be the source of some of its greatest challenges. Patients and care providers in WNC experience barriers to receiving and administering care that are unique and complex due to the rurality of the region's physical (and cultural) landscape. Whether it’s navigating the sometimes treacherous mountainous terrain, the critical gaps in healthcare, public and other infrastructure, or the cautious attitudes of those who have often felt left out of the conversations about their health and wellbeing happening “down the mountain,” these barriers require a combination of creative problem-solving, iterative innovation, and broad collaborative effort to overcome them - luckily, all things that the people and communities of the WNC region excel at.

A key focus area for the HPI is coordinating efforts to establish synergistic working relationships between interested parties across the region in key priority areas — such as rural primary health, Medicaid expansion and transformation, maternal and child health, mental health, substance use disorders, and other similar issues. This work is vitally important for understanding WNC’s challenges, as well as for identifying solutions and opportunities for growth and improvement as we work toward the goal of providing of equitable, affordable, and quality healthcare access to all Western North Carolinians

HA&E WORK GROUPS AND PRIORITIES

Access to Healthcare (formerly Medicaid Expansion Impacts)

In order to ensure all Western North Carolinians are able to access healthcare in a timely, effective and sustainable manner, it is important to understand the various factors, challenges, barriers and opportunities that impact an individual’s ability to locate providers, programs, and facilities that can address their needs, secure and get to appointments, pay for services and medications, and adhere to their medication and treatment plans.

It is additionally vital that we understand the same variables as they apply to providers’ abilities to maintain their patient roster, be fairly and adequately reimbursed for services rendered, manage the demands of both patient and payor administration, and maintain a financially, professionally, physically, and mentally sustainable practice.

This is especially true in the context of Medicaid expansion in North Carolina (and potential upcoming instabilities within that program). Although expansion marked a significant milestone in expanding healthcare access in NC, its implementation comes with equally significant challenges, and delays in or disruptions to these efforts can mean eligible residents might not get needed access to care or might have that care delayed, and that health systems and providers might not be properly reimbursed for providing that care.

Since NC’s expansion involves adding an estimated 600,000 newly-eligible and expanded-services-eligible individuals to rolls, moving into this new era of expanded healthcare access represents a massive undertaking to ensure that our healthcare infrastructure is not strained past the point of breaking. Our HA&E work group is currently focused on addressing healthcare workforce sustainability through the lens of increasing provider participation and workforce expansion to help meet the growing need.

2025 Priorities and Objectives

  • Short-Term: Create the most up to date maps of provider information in WNC to inform conversations about gaps in coverage with policy makers and other stakeholders.

  • Longer-Term: Explore strategies to expand capacity of physical health and behavioral health workforce

2024 Priorities and Objectives (disrupted by Hurricane Helene)

Short-Term – Increase provider participation including mental health providers, specialists, and primary care:

  • Compile and monitor Medicaid data (focused on billing complexity and provider adequacy) to create strategies and investments to grow and maintain the workforce.

  • Share what is learned about what data is currently being tracked around Medicaid providers/billing, and other pertinent data points, as well as create data-driven recommendations for action items that WNC HPI can undertake.

  • Create the most up to date maps of Medicaid provider information to inform conversations about gaps in coverage with policy makers and other stakeholders.

Longer-Term – Expand capacity of physical health and behavioral health workforce