Advancing Community-Based Models of Health and Social Care in North Carolina (2025-2026)
Health outcomes are often influenced by factors that shape people’s lives outside the clinic, highlighting the importance of integrating healthcare and social services. North Carolina Integrated Care for Kids (NC InCK) is a Medicaid demonstration model operating in five North Carolina counties that aims to improve outcomes for children by providing coordinated, family-centered and longer-term care management.
This project explored how community-based organizations (CBOs), often trusted first points of contact for families, can help connect children and families to NC InCK more effectively. The team conducted qualitative interviews with local CBOs that partner with NC InCK to understand their experiences surrounding referrals. They then analyzed the data with a focus on examining how community referrals were implemented. Finally, the team created process flow diagrams to illustrate the major steps in community referral processes, identifying where barriers and facilitators to care occur.
Key findings indicated that referral processes varied widely across organizations and were shaped by the nature of their client interactions. For example, CBOs with repeated in-person engagement with their clients were generally better positioned to incorporate community referrals into their interactions. The team produced practical, implementation-focused insights and recommendations to strengthen referral pathways, support CBO capacity and improve coordination between agencies.
Timing
Summer 2025 – Summer 2026
Team Outputs
Strengthening Referral Pathways Between Community & Health Care Organizations: A Case Study of North Carolina Integrated Care for Kids (NC InCK) (Poster presentation at the Fortin Foundation Bass Connections Showcase, April 15, 2026)
Connecting Children & Families to Care Through Trusted Community Partners (Team profile)
Summary report of research findings and recommendations to share with NC InCK leaders and CBO partners
This Team in the News
Student Profile: Sydney Grube (Master of Business Administration ’26)