This is one section of State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment. See the full resource guide.
For more information on financing housing-related services, please visit our Medicaid and Housing toolkit.
Executive Summary
Health and housing supports and services are critical for many individuals and families to obtain and maintain stable housing in community settings. Most state Medicaid agencies contract with managed care organizations (MCOs) to deliver services to Medicaid beneficiaries. Managed care is a critical option states have to cover housing supports and services and coordinate between health and housing partners.
Some states have already implemented innovative strategies with MCOs to deliver housing supports and services. The following are among the many examples discussed in this report:
Ohio requires its MCOs to invest a percentage of their annual after-tax profits to community reinvestment — a key element of the state Medicaid agency’s strategy to addressing housing instability, among other social determinants of health (SDOH) and initiatives for cross-system collaboration.
Arizona requires its MCOs to employ a housing specialist who serves as a liaison to housing partners to align data systems and better coordinate resources to address an enrollee’s unmet housing needs.
Nevada requires its MCOs to strengthen care coordination for individuals experiencing housing instability by prioritizing enrollees experiencing homelessness for case management, designating a specific clinician or case manager to ensure continuity of services for enrollees experiencing homelessness, and submitting an annual population health strategy to the state Medicaid agency to plan for addressing enrollee SDOH needs.
California supported planning efforts through its housing and homelessness incentive program (HHIP) and leverages the CalAIM Incentive Payment Program (IPP) to encourage MCOs to build necessary infrastructure and capacity so they can provide additional housing supports and services.
When considering these policy changes, it is important to acknowledge the need to coordinate MCO housing strategies with other housing initiatives across the state, such as those financed through Medicaid or federal grant programs. Given the diversity of approaches across states, it is our hope that this resource can be helpful for states seeking to learn from one another.
This is one section of State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment. See the full resource guide.
Acknowledgements
The authors would like to thank Robin Wagner, Elaine Chhean, and all the state officials who reviewed this brief for their thoughtful feedback. This resource is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under the National Organizations of State and Local Officials as part of a three-year award totaling $2,632,044 with 0% financed with non-governmental sources. The information, content, and conclusions are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
