Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan's Permanent Supportive Housing Program

Abstract

This document represents our third report on a permanent supportive housing (PSH) program operated by a large not-for-profit Medicaid and Medicare managed care plan in Southern California. This PSH program combines a long-term housing subsidy with intensive case management services for adult plan members experiencing homelessness who have one or more chronic physical or behavioral health conditions and represent high utilizers of inpatient health care. In this report, we provide an update from our previous reports in terms of program implementation through September 2020, describing participant characteristics, program referrals, enrollment timelines, housing placements, and program exits. We also assess the impact of the program by examining health care service utilization and associated costs in the 12 months prior to and the 12 months following program enrollment, in comparison with an observational control group of adult plan members who were not enrolled into the program. We describe the health care utilization and associated costs between the transitional period (i.e., after program enrollment but before receipt of housing) and the housed period (i.e., after individuals are placed into PSH). Finally, we report PSH programmatic costs to provide an overall picture of the impact of the program on payer costs. This report should be of interest to public and private health care organizations and other entities considering the potential of PSH programs to lower their costs, improve service quality, and reduce homelessness in their communities. The Inland Empire Health Plan sponsored this research. Community Health and Environmental Policy ProgramRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was conducted in the Community Health and Environmental Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as infrastructure, science and technology, community design, community health promotion, migration and population dynamics, transportation, energy, and climate and the environment, as well as other policy concerns that are influenced by the natural and built environment, technology, and community organizations and institutions that affect well-being. For more information, email