Case studies: Hospitals help homeless patients find housing

Finding homes for the expensive, homeless Medicaid enrollees saved programs money

Hospitals and Medicaid programs in California, Minnesota, and New York are helping some of their most expensive patients find housing in an effort to reduce readmission rates and high costs of care.

The initiative comes amid growing financial pressures and model changes for the Medicaid program, which could gain up to 13 million additional enrollees in 2014, depending on how many states opt into the Affordable Care Act's Medicaid expansion.

New York: Pilot program finds hospital for Medicaid patients

In New York City, the Health Department has funded a three-year pilot program that finds housing for high-cost Medicaid enrollees. Preliminary results indicate that monthly Medicaid spending for beneficiaries enrolled in the pilot decreased by 20% to $3,426. In addition:

  • Hospitalizations decreased by 47% and hospital spending decreased by 27%; and
  • ED visits decreased by more than 50% and ED spending decreased by 30%.

Altogether, New York officials believe that housing and supportive services for chronically ill Medicaid patients could save the program as much as $1.3 billion over five years.

As such, they are expanding the pilot program and have requested $375 million in funding from CMS to construct or renovate 3,000 apartments to house high-cost Medicaid enrollees.

California: Cities plan to house homeless patients

In San Francisco, city officials are planning a nine-story building to house 172 chronically ill and homeless enrollees who frequently visit the ED and receive hospital care. The building is expected to open by the end of the year.  

A recent analysis of patients enrolled in the San Francisco Health Plan—a Medicaid managed-care plan—finds that many of the patients who required the most medical care were either homeless, mentally ill, and/or misused substances.

Meanwhile, 11 Los Angeles hospitals, six safety-net clinics, and more than a dozen government agencies plan to launch a similar initiative in October to bring down costs for 107 of its most expensive adults patients. An earlier initiative in Los Angeles obtained housing for a dozen costly patients.  

Minnesota: Hospital hires coordinators to find 14 patients housing

In Minnesota, Hennepin County Medical Center has housed 14 costly Medicaid enrollees since January. The hospital hired two housing coordinators to sift through rentals and meet with landlords to find homes for the chronically ill patients.

In the six months before finding housing, the patients were collectively hospitalized six times and visited the ED 18 times. In the six month since they were placed in housing, the patients were hospitalized twice and visited the ED three times (Evans, Modern Healthcare, 9/22 [subscription required]).

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