Health & Housing in Delaware:: Matching Medicaid Claims and Encounters and the Community Management Information...

Area of Science:

• Health Services Research
• Public Health
• Health Economics

Background:

• Homelessness significantly impacts healthcare utilization and costs.
• Medicaid beneficiaries experiencing homelessness represent a vulnerable population with complex health needs.

Purpose of the Study:

• To quantify the excess healthcare costs associated with homelessness among Medicaid-eligible adults.
• To compare healthcare utilization and costs between individuals experiencing homelessness and housed Medicaid enrollees.

Main Methods:

• Data linkage between Medicaid claims and Homeless Management Information System (HMIS) records.
• Propensity score matching to create comparable housed and homeless cohorts.
• Ordinary least squares regression to analyze cost differences.

Main Results:

• Homelessness was associated with excess healthcare costs of $4,611 for non-chronic and $5,218 for chronic homelessness per person in 2019.
• Comorbidity scores, substance use disorder incidence, and healthcare visit patterns were compared between groups.

Conclusions:

• Homelessness represents a significant financial burden on the Medicaid system.
• Targeted interventions and supportive housing may mitigate these excess healthcare costs.