Pathways to Sustain Evidence-Based, Whole-Person Preventive Care Interventions in Medicaid
Case Studies & Resources for State Leaders
The Big Picture
States are navigating significant policy and budget pressures while working to sustain innovative Medicaid benefits that advance whole-person health. In light of this policy environment, the West Health Accelerator at Duke-Margolis has created the State Rapid Learning Collaborative (SRLC). The aim of the SRLC is to ensure Medicaid enrollees receive high-quality, whole person preventive care that addresses upstream drivers of health by helping states leverage technology and generate evidence on cost and value impacts as they navigate implementation of HR1 requirements and increasing budget pressures.
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The Accelerator team at Duke-Margolis is working with state leaders and experts to advance this aim by compiling resources and evidence-based examples. Explore the materials below to learn more about programs and interventions, the authorities states can use, evaluation results, and case examples. This page is a living resource; content will be updated and expanded over time to reflect our ongoing work and emerging information.
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Surveying Innovative Medicaid Service Models
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Programs addressing upstream drivers of health, such as food and housing insecurity, are frequently elevated as essential components of a whole-person care model, and the interventions outlined in the below matrix reflect examples of how states are operationalizing that vision. The matrix maps a set of Medicaid service benefits to the patient populations they target, the legal and regulatory authorities that enable them, and the evidence of their impact. Together, these examples illustrate how states can leverage different Medicaid authorities to advance a whole-person model of health.
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This matrix is intended as a working illustration of how states might categorize and evaluate innovative Medicaid service interventions. It does not represent an exhaustive inventory of existing programs or available authorities, and intervention impact data is drawn from select state pilots and published evaluations for demonstration purposes only.
Click here to download the full table
States’ Available Authorities
This reference guide summarizes key Medicaid authorities available to states seeking to build and expand their innovative benefits programs. It covers waiver pathways, state plan authorities, and managed care mechanisms, including their purposes, federal approval requirements, and applicable oversight standards. The authorities outlined here do not represent every available option but cover commonly leveraged tools for driving innovation in Medicaid benefit delivery, offering states a practical reference point for comparison as they evaluate their options.
Click here to download the full table
Innovative Prevention-Oriented Program Case Studies
This collection will be iteratively expanded, with additional case studies added and existing examples updated to incorporate new developments and evidence.
North Carolina Health Opportunities Pilots
The Healthy Opportunities Pilots are a North Carolina Medicaid program designed to advance whole-person, prevention-oriented care for the state's highest-need populations. Authorized under a Section 1115 Medicaid Waiver demonstration, the Pilots direct Medicaid funding toward the root causes of avoidable health care utilization and chronic disease by delivering targeted interventions to address health-related social needs (HRSNs).
June 9, 2026