Appendix: Implementation Considerations

The following visualization depicts how our recommendations vary based on their estimated costs (time, information technology, and personnel), equity implications, and stakeholder support (see the legend below for specifics). These determinations were made based on background research and stakeholder interviews. The purpose of this matrix is to summarize the high-level implications of our recommendations, and ultimately help NC DHHS prioritize the recommendations.

Short/Medium/Long Term:

ST NC DHHS can implement quickly/without additional funds

MT NC DHHS can implement over a few years/with additional funds LT NC DHHS can implement over a few years/with new legal authority

Matrix Legend

Requires Legal Authority:

No Does not require legislation

Yes Does require legislation

Stakeholder Support: Almost universal agreement among stakeholders that this was a priority Some agreement among stakeholders that this was a priority No agreement among stakeholders that this was a priority

Equity Implications: Addresses equity Is neutral on equity Works against equity

Initial Costs to the State: Has small cost (less than $100,000) Has a moderate cost (approximately $100,000 - $500,000) Has a significant cost

Administrative Capacity: Requires only a few people Requires a moderate number of people and/or IT resources Requires a significant number of people and/or IT resources

Recommendation ST/ MT/ LT Requires Legal Authority Stakeholder Support Equity Implications Initial Costs to the State Administrative Capacity

Part I. SCD and MCH Shared Recommendations Rural Health ST No Transportation MT No Provider Bias Training ST No Non-Medical Drivers of Health MT No Data Gaps MT No Part II. SCD Recommendations Care Management MT No Access to Care and Services MT No Clinical Care ST No PHP Contracts MT No Payment Models LT Yes Part III. MCH Recommendations Care Management MT No Care Services MT No Access to Care and Services LT Yes Quality Measures MT No Administrative Burden LT Yes