In the United States, there are more than 2 million people in public housing. Stable housing is a major social determinant of health — that is to say, the conditions where people live and work that affect one’s health. But in many communities, residents face a fragmented system that silos physical health, behavioral health, social services and housing. This might make it more difficult for them to access things that make up a healthier life – everything from an integrated care team to nutritious food. Examples of these disparities pop up throughout the country:
- In King County, Washington public housing residents make up 11 percent of the Medicaid population.
- In Austin, 76 percent of public housing residents have a chronic disease.
- Nationwide, children in subsidized housing have the lowest rate of enrollment into kindergarten.
In order to help address these disparities, UnitedHealthcare, along with the Council for Large Public Housing Authorities (CLPHA), local public housing authorities and the Corporation for Supportive Housing (CSH) has begun an ambitious collaboration. In five metro areas in three different states, public housing authorities are working with UnitedHealthcare to identify possible health care interventions that make the most sense for its Medicaid members. This might mean targeting specific chronic conditions or increasing access to providers; for example, with an on-site clinic.
This collaboration could improve people’s lives with better health care outcomes, and provide a nationwide model for others in the future.
“For too long the two industries have been on parallel paths,” said Catherine Anderson, senior vice president, Policy & Strategy for UHC Community & State. “The reality is that we are interdependent.”
The scale of this project is made possible with data, both from UnitedHealthcare and the public housing authorities themselves. Sifting through a set of data to find specific population health trends, UnitedHealthcare is able to analyze claims and population statistics to understand health care demographics while maintaining HIPAA compliance and privacy for its members. This will include data about chronic diseases, behavioral health and substance use diagnoses, rates of ER visits and the frequency of routine checkups with a primary care physician.
The locations — Akron and Columbus in Ohio, Austin and Houston in Texas, plus Seattle in Washington State — were chosen to develop their own multi-pronged strategy to improve the health of individuals with Medicaid who live in publicly assisted housing. The goal is to focus on improving the overall health of these communities and address social determinants of health.
Of course, hotspotting is only the first step.
“The data is only telling us the questions that we ask,” said Sonja Nelson, of the Columbus Metropolitan Housing Authority.
This is why the expertise of people in these local communities is so important for asking the right questions. From here, specific evidence-based interventions can be designed for these individual communities, with the state UnitedHealthcare Medicaid plan and public housing authorities working in tandem.
Stable housing has been shown to make major improvements in the quality of life and health outcomes of the people who need it. Conversely, large public housing authorities and other advocates of affordable housing have had an increasing interest in the health and wellness of the people they serve. For example, CLPHA, which represents the 70 largest public housing authorities that together serve 1 million residents, has developed an initiative called “Housing Is” that focuses on issues like environmental health, accessibility for residents with disabilities and health care partnerships.
Likewise, in an effort to help remove social barriers to health, UnitedHealthcare has invested more than $400 million in affordable housing projects since 2011.
Ultimately, the long-term goal of the collaboration is to develop “health-plan agnostic” solutions that can be scaled by UnitedHealthcare and other Medicaid health plans for low-income individuals in a number of communities, regardless of their health plan coverage.
“We want this to be the seed that grows the forest,” said Marcella Maguire, director of Health Systems Integration for CSH.
To find out more about this ongoing collaboration, visit UnitedHealthcare Community & State and watch the video.