A growing number of states are covering housing-related services under Medicaid, including pre-tenancy and tenancy-sustaining services. Many states leverage their contracts with managed care organizations (MCOs) to support housing-related interventions. Regardless of whether a state has pursued an 1115 waiver or other Medicaid authority, Medicaid MCOs can be an important player in developing partnerships and coordinating resources to deliver housing supports and services.
The goal of this report is to highlight examples of how state Medicaid programs are leveraging their managed care contracts and policies to pursue health and housing alignment and address the housing needs of beneficiaries. The strategies are organized into subsections that can be read as standalone resources, as well as part of the overarching document. The sections are:
- Executive Summary: State Strategies to Leverage Medicaid Managed Care Contracting for Investments in Health and Housing Alignment
- Leveraging Managed Care to Expand Housing Resources and Formalize Partnerships
- Using Managed Care to Identify and Address Individuals’ Housing Needs
- Using Data and Performance Measurement to Guide MCO Efforts to Meet Housing Needs
- Paying MCOs to Address Housing Challenges
To learn more about this topic, check out our toolkit, Medicaid and Housing: State Strategies to Support Housing-Related Services.
Aligning Health and Housing Supports and Services
For decades, state leaders have pursued a variety of strategies to align affordable housing, rental assistance, and supportive services to assist individuals in finding and maintaining stable housing. The health care sector is increasingly investing in supportive housing solutions, recognizing the evidence that stable housing has a positive impact on one’s health and well-being. Successful approaches require aligning resources and coordinating across health, behavioral health, human services, and housing sectors.
When we say “health and housing supports and services,” we refer to services that help individuals obtain and maintain stable housing in community settings. This might include case management, pre-tenancy or tenancy services (such as housing search, applications, deposits, and/or modifications), referrals to social supports (such as employment or nutrition resources), and physical and behavioral health services. This is not a comprehensive list of the services that might be offered — please visit the U.S. Interagency Council on Homelessness website for additional information.
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.