PA Department of Human Services Study Finds Positives Effects for Medicaid Recipients with Housing Support

Harrisburg, PA Department of Human Services (DHS) Secretary Teresa Miller announced the findings of a study on the effects of permanent supportive housing programs on long-term health and health care spending among Medicaid recipients experiencing homelessness. The study, conducted in partnership with the University of Pittsburgh’s Medicaid Research Center, looked at nearly 5,900 cases from 54 Pennsylvania counties who received permanent supportive housing services from 2011-2016 and found that people who experienced homelessness saw improving health outcomes and decreased Medicaid utilization and spending after receiving permanent supportive housing services.
“We know that a person’s health is more than what happens inside of a doctor’s office,” said Sec. Miller. “These environmental factors, known as social determinants of health, play a key role and can take many forms, including safe and affordable housing. We are always looking for ways to help people experiencing homelessness improve their health and overall quality of life. This report gives us an initial set of data to work with to achieve those goals.”
DHS is committed to supporting vulnerable Pennsylvanians like those who experience homelessness. By identifying positive trends in health outcomes and health care spending among people who received permanent supportive services, DHS can make data-driven, evidence-based decisions to broaden investments in programs and positive interventions that can help people experiencing homelessness long-term.
Low-income individuals with physical and behavioral health conditions have an elevated risk of homelessness. Permanent supportive housing programs provide long-term housing assistance and support services to individuals with disabling physical and mental health conditions experiencing chronic homelessness.
Among the population studied, 90 percent had a minimum of two chronic health conditions, and 43 percent had seven or more. Medicaid spending for this group averaged more than $1,200 per month in the 7-15 months before people began permanent supportive housing services. Significant, chronic behavioral and physical health conditions can contribute to housing insecurity, and unstable housing can make it difficult for these individuals to manage their health care needs.
Following the introduction of permanent supportive housing services, spending stabilized and declined. The study found that by the third year after beginning permanent supportive housing, total Medicaid spending fell by an average of $162 per person, or 13 percent, each month. Changes in spending were primarily reductions in spending on inpatient care for both behavioral health and non-behavioral health conditions and a 22 percent decline in emergency department use. Instead, cases analyzed showed increased case management and pharmaceutical use, showing a shift towards management of chronic conditions as opposed to dealing with these conditions through emergency or inpatient settings.
“This report affirmed our perspective that housing people experiencing homelessness is both the right thing to do for their health and well-being and is a cost-effective approach,” said Sec. Miller. “Sustaining housing for those that have it—and establishing housing for those that don’t—is a centerpiece of our strategy to address the social determinants of health and help people live healthy and fulfilling lives, and we will continue to look for opportunities to meet this need among people who need it.”
Read the report here.
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