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Two top Obamacare officials spent years in their Washington offices, right next door for a time, thinking about how to fix health care. Then both came to North Carolina, determined to put their ideas to the test in the real world. One runs the state Health and Human Services Department, including Medicaid. The other led the state’s dominant private insurer. Combined, they cover well over 6 million people, more than half the state. Together, they made North Carolina arguably the most innovative state in the country when it comes to improving how health care is delivered and addressing the underlying social and economic drivers, like homelessness, of poor health and high costs. (Kenen, 10/24)

North Carolina has embarked on an ambitious attempt to shift health care payments so they reward the value of care, not the volume. Working largely through Medicaid and North Carolina’s dominant private health insurer, the state is also addressing social and economic drivers of poor health, like homelessness. Here’s how that’s working in practice for three providers: an urban safety net hospital, a small-town family doctor and a community clinic. (Kenen, 10/24)