On October 31, the WNC HPI convened with our working group leads for a briefing to share progress and align next steps across the WNC HPI’s three core focus areas: Social Drivers of Health (SDOH), Access to Healthcare, and Healthcare Workforce Development. In this summary update, we share key takeaways, themes and action items drawn from the Oct 31 briefing to provide a roadmap of the working group’s activities over the next several months.

Medicare Advantage (MA), also known as Part C, has become the dominant path through which older adults receive Medicare coverage. More than half of all beneficiaries — roughly 33–34 million people — are enrolled in plans operated by private insurers. These plans promise convenience and financial protection, including caps on out‑of‑pocket spending and some extra benefits not found in Original Medicare. At the same time, MA brings challenges that stem directly from how the program is designed, and these structural incentives can affect access to timely care, especially for people with complex health needs or limited provider options.

Across America, 41% of adults struggle with medical bills they cannot pay, a situation that comes with significant financial, emotional and even physical costs, including reduced access to necessary healthcare. On July 26th, 2024 North Carolina Governor Roy Cooper and the NC Department of Health and Human Services took a huge step toward alleviating that burden with the introduction of the Medical Debt Relief Incentive Program, which will eliminate medical debt for millions of Medicaid recipients and middle- and low-income residents across the state. 

North Carolina ranks 39th in the nation for access to mental health care. Four million state residents — two in every five North Carolinians — live in an area with a mental health professional shortage and the situation is worse in rural counties, which have only 0.58 psychiatrists to every 10,000 people, compared to 1.79 per 10,000 in urban ones. 

While the APA indicates that telehealth can be especially effective for depression, ADHD, and PTSD, not all mental health conditions are equally suited for telehealth.  However, with such a severe mental health provider shortage in the region, doctors and patients — especially those in rural Western North Carolina — have to rely on telehealth, provided they have sufficient internet access. (Reprinted with permission from Carolina Public Press)