"I always thought this was a great job," said Greenblatt.
Having the opportunity to reunite with former Duke Health colleague and current NCDHHS Secretary Dr. Dev Sangvai, while implementing and advancing state health policy, was just that opportunity.
"It's my role to bring my medical background and skills, my ability to communicate, to assess the situation, to work in a team and to respond," said Greenblatt.
For about the first half of his career at Duke, Greenblatt worked as strictly a clinician, before taking on additional responsibilities starting in 2008.
"I got involved with Medicaid leadership activities, so a good part of my work there was administrative. It was trying to support our practices, support our patients. I also had a number of roles at the state level involved with Medicaid policy," said Greenbalatt.
It's experience proving useful in this role, as the agency navigates the potential of shifting policy stemming from the federal government.
"We have a lot of financial challenges with changes in Medicaid funding potentially under way from the federal government. We may see a reduction or an elimination even of the SNAP program," said Greenblatt.
According to NCDHHS, more than 1.4 million North Carolinians utilize SNAP, with a larger percentage of use coming from rural areas or small towns.
One report published in the American Journal of Public Health found that older adults' participation in SNAP led to fewer hospital admissions and emergency department visits, and an estimated Medicaid-cost savings of $2,360 per person annually.
"We certainly need to be communicating with our federal government about the impacts of Medicaid changes and what that can do to rural hospitals. We don't want rural hospitals to cut off services or even worse, to close altogether. And I think there's some risk of that if we see our Medicaid enrollment drop significantly. We've been advocating for how does the Medicaid program affect people in North Carolina," said Greenblatt.
As North Carolina continues to see rapid population growth, Greenblatt discussed efforts to ensure medical coverage across the state.
"We just need to to try to build up the infrastructure, make practicing in a rural community a great place to be so that people will see that's a great place to raise a family, to have a career, to practice medicine or practice nursing," said Greenblatt.
Earlier this month, he was named Co-Chair of the State Advisory Council on Cannabis. While polling shows overwhelming support among North Carolinians for medical marijuana legalization, thus far bills in the General Assembly have stalled.
"There is an illegal market for cannabis and there are plenty of people using it, but it's possible for the state to get involved and to regulate. My role is to really think about the public health impacts," said Greenblatt.
One area the state has found bipartisan agreement: combatting opioid overdoses. Data from NCDHHS shows after four consecutive years of increasing emergency department visits for opioid overdoses, there was a 29% drop in 2024. Through April of this year, that figure has dropped 24%.
"Medicaid has a really robust addiction treatment program. There's funding for the individuals who are now receiving medication such as buprenorphine products. They don't have to pay a co-pay. They can get their naloxone covered (without a co-pay). The services for counseling or addiction specialty care can be funded," said Greenblatt, who co-chaired the Duke Opioid Safety Committee.
He hopes to serve as a communicator to the public, helping to address medical misinformation.
"I'm going to try to be a counter to that and make sure people have easy access to high quality information," Greenblatt said.