Participant Needs, Service Utilization, and Costs in a Medicaid Housing Pilot Program

Area of Science:

• Health Services Research
• Health Equity
• Social Determinants of Health

Background:

• Housing instability and homelessness significantly impact health outcomes and healthcare costs.
• State Medicaid programs are increasingly recognizing the need to address housing as a health-related social need.
• Effective partnerships between healthcare and housing sectors are crucial for improving health equity.

Purpose of the Study:

• To evaluate the implementation and initial outcomes of a housing benefit pilot program for Medicaid members.
• To identify participant characteristics, their needs, and service utilization within the program.
• To understand the costs associated with providing housing benefits through Medicaid.

Main Methods:

• A cohort study design was employed for a pilot program in the Portland, Oregon metropolitan area.
• The program provided temporary rental assistance, housing navigation, and other supports to Medicaid members for up to 12 months.
• Data on participant demographics, needs, service utilization, and program costs were analyzed.

Main Results:

• 517 individuals enrolled, with primary needs including rent (74.1%) and utility (54.5%) support.
• Frequently reported non-housing needs included employment (42.3%), food (41.8%), and mental health (25.8%) services.
• The mean cost per member per month was $2225 ($1586), with modifications made to services due to capacity challenges.

Conclusions:

• The pilot provides critical insights into the services and costs associated with housing benefits as a Medicaid offering.
• Significant participant needs underscore the necessity for cross-sector collaboration between healthcare and housing organizations.
• Findings offer valuable lessons for designing and implementing housing support programs under Medicaid in Oregon and other states.