Related Experiment Video
Updated: Sep 21, 2026
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Medicaid waiver-based housing supports in a safety-net setting: utilization and spending outcomes
Nicole C McCann1, Heather E Hsu2,3, Stephanie Ettinger de Cuba1,3
1Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA 02118, United States.
Introduction:
States have expanded Medicaid waiver-based housing support programs, but evidence on outcomes in safety-net settings is limited.
Methods:
We evaluated health care utilization and spending associated with Massachusetts Medicaid's Flexible Services Program housing supports (FSP-H), provided to Accountable Care Organization (ACO) members with housing-related needs and qualifying health risks (2021-2024). Within a Boston-based safety-net health system, we linked FSP-H data to claims and electronic health records. Using staggered difference-in-differences, we compared monthly probability of inpatient and emergency department (ED) utilization and per-patient spending in FSP-H recipients (n = 340) vs a contemporaneous comparison group with documented housing-related needs who were FSP-H-ineligible because they were in non-ACO plans (n = 425). We conducted clinical risk-based subgroup analyses.
Results:
Overall, FSP-H receipt was not associated with significant changes in monthly probability of inpatient utilization (-3.3 percentage points, P = 0.223), ED utilization (-1.5 percentage points, P = 0.569), or monthly spending (-$634, P = 0.053). Massachusetts Medicaid's Flexible Services Program housing supports (FSP-H) was significantly associated with lower monthly inpatient utilization in the substance use disorder and frailty subgroups and with lower monthly spending in the frailty subgroup.
Conclusion:
Findings offer evidence for state Medicaid plans implementing or adapting housing programs.
Related Concept Videos
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include: