People without stable housing often turn to hospital emergency departments when they feel they have nowhere else to go for medical care. That's one reason why Medical Home Network Accountable Care Organization (MHN ACO) is investing in a "housing first" program to care for patients without stable housing who are at high risk for poor health outcomes.
The program is funded by the MHN ACO, a wholly provider-owned entity comprised of 13 Federally Qualified Health Centers and three hospital systems. Through its partnership with CountyCare—a Medicaid plan for Cook County residents—the MHN ACO reinvests a portion of the shared savings it earns back into the community through initiatives like the Flexible Housing Program. CountyCare is also investing its own dollars in the housing program.
"The MHN ACO reinvests our savings to provide essential services – or services not covered under insurance but vital to health," said Cheryl Lulias, president and CEO of MHN ACO and president and CEO of Medical Home Network. "We are proud to invest in stable housing as it is a significant determinant of health."
The 3-year pilot program launched in September underwrites rent subsidies to help a select number of Cook County's safety-net population settle into apartments. Community care coordinators connect patients with primary and specialty care, employment assistance and social services. One-on-one follow-up will keep residents engaged in their care plans.
"It's challenging to improve the health of patients when their most basic need–housing–has not been met," said Leana Lopez, director of behavioral health and community programs at MHN. "When patients have consistent shelter, washing facilities, storage for medicines and a care team dedicated to their well-being, the physical and mental healing can begin."
Housing Intervention Halts Healthcare Cost Spiral
The Flexible Housing Pool program was developed by the Center for Housing and Health in collaboration with Cook County Health, the City of Chicago and support from foundations and healthcare and social service providers.
After treatment, patients typically return to the streets only to cycle back to the emergency department when their conditions worsen. A local pilot study at the University of Illinois at Chicago found that 48 percent of the people who frequently used the emergency department for care were homeless. UIC also found that one hospital admission costs about five times as much as 30 days of supportive housing. To help reduce costs and support whole person care, the program has medical, emotional and financial benefits.
"One of our most complex patients at Lawndale recently received housing this past year in a similar program," said Adam Claus, complex care manager at Lawndale Christian Health Center; one of MHN ACO's member organizations. "The previous year he had 20 psych admissions and struggled with any stability as he had no place to feel safe and secure. Since he's received housing, he has had no admissions."
The pilot period will gather more evidence to connect stable housing and stable health conditions. "Claims data will show whether heart failure or hypertension are being managed, A1c levels for diabetes are under control and patients are engaging with behavioral health services—after people receive stable housing," said Lopez.
About Medical Home Network Accountable Care Organization
Medical Home Network Accountable Care Organization (MHN ACO) is a provider-owned and driven approach to patient-centered healthcare delivery and population health management for Medicaid patients. Our members include 13 Federally Qualified Health Centers, three Hospital Systems, and their Physician Practices. Within our ACO we strive to create a different kind of culture – one that includes shared decision-making and is focused on change, innovation, collaboration and delivery improvement for all our member/owners. For more information, visit www.mhnaco.org.
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