News

February 20, 2018

Housing as Healthcare: UAlbany Researchers Evaluating Supportive Housing as Part of New York State’s Medicaid Redesign Initiative

Research team found a 15 percent reduction in Medicaid costs and a 40 percent reduction in inpatient days among supportive housing recipients.

Early evaluatio

n findings have demonstrated that individuals served by the New York State Department of Health’s Medicaid Redesign supportive housing initiative experienced a 15 percent decrease in Medicaid spending during the study period, according to researchers from the University at Albany’s Center for Human Services Research and Institute for Health System Evaluation.

Additionally, individuals in supportive housing experienced a reduction in intensive and high cost Medicaid services, including a 40 percent reduction in inpatient days and more than 25 percent fewer emergency room visits.

In sum, the over 2,000 individuals studied saw their Medicaid expenses fall from $85,154,898 to

$72,459,687, according to Cost Report 1, available on the NYS DOH website.

“If I wasn’t in this program, I don’t know where I’d be,” said Vivian McIntosh, a client receiving supportive housing through St. Catherine’s Center for Children. “They took me off of the streets and got me in a home.”

UAlbany’s Involvement

The research team, led by Lauren Polvere, senior research scientist at UAlbany’s Center for Human

Services Research, analyzed cost and utilization data from 11 of the Medicaid Redesign Team’s housing-related programs. This study documented early positive findings from the first year of a three-year comprehensive evaluation.

A comparison group will soon be added to more clearly isolate the potential impact of supportive

housing on costs, service utilization, and quality of life, according to Polvere.

“In Year 1 of the evaluation, we saw reductions in the utilization of high-cost Medicaid services,” Polvere said. “These preliminary findings, drawn from a pre-post study design, suggest that individuals with complex needs are benefiting from supportive housing.”

Polvere said this may be due in part to the role of housing in stabilizing the participants’ lives, as well as being recipients of support services that enable them to better manage their health conditions.

About the Medicaid Redesign Team (MRT) Supportive Housing Initiative

The initiative reinvests Medicaid dollars for supportive housing of high-need populations. This supportive housing initiative is the largest investment in housing by any state health agency in the nation, and has served over 11,000 high acuity Medicaid members in the past five years. Participants served have serious health conditions — two of every three participants have a serious mental illness, nearly half report a substance use disorder, and 40 percent are HIV positive.

In addition to stable housing, the initiative provides comprehensive support services to foster improvements in health and quality of life.  Many of the individuals served by the programs are homeless or at risk for homelessness, a group known to face significant health risks that require high cost interventions.  In addition, the programs serve individuals transitioning from institutional settings, such as nursing homes, who can live in the community with the proper supports in place.

The New York State Department of Health is focused on addressing the “social determinants of health”, such as housing, as evidence suggests that such determinants are critical to improving health and quality of life.  Investments in housing have been shown to reduce overall healthcare costs, as well as system-level cost reductions from jail and shelter usage.

Since 2012, DOH has funded numerous supportive housing programs to “provide vulnerable, high-cost Medicaid members with rental subsidies, new capital construction and pilot projects to test new models of care,” according to their site.

LINK TO VIDEO: https://www.youtube.com/watch?v=YDOgNAgP_aQ&feature=youtu.be