New analysis quantifies HOP’s ripple effects across diverse WNC sectors and industries
Asheville, NC—A newly released economic impact analysis reveals that North Carolina’s Healthy Opportunities Pilot (HOP) significantly boosted the economy in Western North Carolina’s 18 westernmost counties. The analysis shows that HOP generated $114 million in economic output and supported 898 full-time equivalent jobs between March 2022 and June 2025.
“HOP’s ultimate goal is to create a healthier North Carolina by addressing critical health-related needs, but its role in creating a healthier economy is undeniable,” said Impact Health CEO Laurie Stradley. “This report shows what we already knew: HOP is a catalyst for economic activity, job creation, and sectoral growth in Western North Carolina.”
HOP uses NC Medicaid funds to provide health-related services such as access to healthy food, housing support, transportation, and services that support safe relationships — all aimed at reducing the need for costly emergency medical care. Research indicates that these factors influence up to 80% of a person’s wellbeing. Impact Health is the regional network lead for HOP in Western North Carolina, supporting the work of more than 60 human service organizations operating in the 18 westernmost counties and the Qualla Boundary.
“This analysis shows that every service dollar invested in HOP generates an additional $0.53 in economic activity in our region,” Stradley shared. “Industries that benefit from HOP investments extend well beyond direct service providers, affecting those working in agriculture, construction, retail, wholesale, real estate, and insurance industries, to name a few.”
The economic impact analysis shows that total HOP service spending over the course of three years was approximately $75 million, with over $48 million directed toward food services, $23 million for housing support, nearly $3 million for transportation services, and more than $400,000 for interpersonal violence programs and cross-domain programs. This spending produced a total economic output of $114 million, supporting 898 jobs and contributing over $36 million in total labor income.
Despite this impressive track record, HOP is not currently funded in the proposed NC biennial budget. HOP proponents maintain that the omission stands to cost the state significantly in the long run, both in terms of population health and the state’s rural economy.
The economic analysis, produced in June 2025, utilizes the IMPLAN input-output methodology to understand the broad ripple effects of HOP investments. This analysis underscores how strategic investments in health-related social needs can drive economic resilience and community wellbeing, particularly in rural regions of the state. The analysis was conducted by Alison Davis Ph.D., professor of agricultural economics and executive director of Blueprint Kentucky, an integrated engagement/research center at the University of Kentucky.
