Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program.

IF 8.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Health Affairs Pub Date : 2024-02-01 DOI:10.1377/hlthaff.2023.01044
Katie Huber, Raman Nohria, Vibhav Nandagiri, Rebecca Whitaker, Yolande Pokam Tchuisseu, Nicholas Pylypiw, Meaghan Dennison, Brianna Van Stekelenburg, Amanda Van Vleet, Maria Ramirez Perez, Madlyn C Morreale, Andrea Thoumi, Michelle Lyn, Robert S Saunders, William K Bleser
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Abstract

North Carolina Medicaid's Healthy Opportunities Pilots program is the country's first comprehensive program to evaluate the impact of paying community-based organizations to provide eligible Medicaid enrollees with an array of evidence-based services to address four domains of health-related social needs, one of which is housing. Using a mixed-methods approach, we mapped the distribution of severe housing problems and then examined the design and implementation of Healthy Opportunities Pilots housing services in the three program regions. Four cross-cutting implementation and policy themes emerged: accounting for variation in housing resources and needs to address housing insecurity, defining and pricing housing services in Medicaid, engaging diverse stakeholders across sectors to facilitate successful implementation, and developing sustainable financial models for delivery. The lessons learned and actionable insights can help inform the efforts of stakeholders elsewhere, particularly other state Medicaid programs, to design and implement cross-sectoral programs that address housing-related social needs by leveraging multiple policy-based resources. These lessons can also be useful for federal policy makers developing guidance on addressing housing-related needs in Medicaid.

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通过医疗补助计划满足与住房相关的社会需求:北卡罗来纳州健康机会试点计划的经验教训。
北卡罗来纳州医疗补助计划(Medicaid)的 "健康机会试点"(Healthy Opportunities Pilots)项目是该国首个综合项目,旨在评估向社区组织支付费用,由其向符合条件的医疗补助计划参保者提供一系列循证服务,以满足与健康相关的四个社会需求领域(其中之一是住房)的影响。我们采用混合方法绘制了严重住房问题的分布图,然后考察了三个计划地区的健康机会试点住房服务的设计和实施情况。我们发现了四个贯穿各领域的实施和政策主题:考虑住房资源和需求的差异以解决住房不安全问题、在医疗补助计划中对住房服务进行定义和定价、让不同部门的利益相关者参与进来以促进成功实施,以及开发可持续的财务交付模式。这些经验教训和可操作的见解可以帮助其他地方的利益相关者,特别是其他州的医疗补助计划,设计和实施跨部门计划,通过利用多种政策性资源来满足与住房相关的社会需求。这些经验也有助于联邦政策制定者在医疗补助计划中制定解决住房相关需求的指南。
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来源期刊
Health Affairs
Health Affairs 医学-卫生保健
CiteScore
15.00
自引率
2.10%
发文量
246
审稿时长
3-6 weeks
期刊介绍: Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.
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