By Jennifer Norris, UTHealth Houston School of Public Health
Affordable housing communities that partner with a managed care organization may reduce the use of emergency and urgent care of residents, according to a study by a team of researchers at UTHealth Houston School of Public Health and funded in part by Episcopal Health Foundation.
Jack Tsai, PhD, professor and regional dean at UTHealth Houston School of Public Health in San Antonio, led a team of researchers in conducting the study over a 12-month period, through a partnership with Prospera Housing Community Services, a non-profit affordable housing developer, owner, operator, and service provider, alongside Superior HealthPlan, the largest Medicaid provider in Texas.
“This evaluation allowed us to provide a first look at a unique partnership. Many managed care organizations are looking to address non-medical drivers of health, and this evaluation shows what may be possible when they partner with housing providers,” Tsai said.
The study compared the healthcare outcomes of participants covered by Superior HealthPlan who were living in Prospera housing to those who were not. Each group had 104 participants and their use of healthcare and associated costs were examined, including use of inpatient care and emergency and urgent care visits. The Prospera+Superior collaborative model allowed for facilitated and joint programs aimed at improving social determinants of health, including access to nutritious foods, transportation, affordable health care and secure housing.
According to the data, participants who had both Superior healthcare coverage and Prospera housing had a 56% lower rate of emergency or urgent care visits compared to those who had Superior healthcare, but did not live in Prospera housing.
In addition, healthcare costs, in particular pharmacy expenses for the Prospera and Superior group, were also lower, with that group spending about $2,000 less than the Superior-only group.
Michelle Murdock, vice president of operations of complex care programs at Superior HealthPlan, said it was clear this partnership between Prospera and Superior would be beneficial.
“It seems logical for a managed care organization and affordable housing partners to combine their strengths and develop something together, versus each of us building something on our own,” Murdock said. “The study substantiates that not only does it make sense, it saves cents. This helps reduce healthcare costs for preventable events, such as an emergency room visit.”
Carmen Hancock, vice president of managed care relationships at Prospera Housing Community Services, also agreed that the results of the study show the effectiveness of collaborative community care.
“This is valuable evidence to support the critical intersection of healthcare and housing, and the importance of working together to address the holistic needs of our most vulnerable communities,” Hancock said. “This study has demonstrated that combining the stability of housing (Prospera) with access to healthcare (Superior) and the elimination of barriers to overall well-being (collaboration) has value: clinically, economically, and to overall quality of life.”
Shao-Chee Sim, EHF’s vice president for research, innovation, and evaluation, said this study underscores the impact of non-medical factors on health, and that industry leaders have already shown they are committed to this broader understanding of health.
“This evaluation comes at a critical time,” Sim said. “Earlier this year, the Texas Health and Human Services Commission released its Non-medical Drivers of Health (NMDOH) Action Plan, which sets a vision for Texas Medicaid. Meanwhile, managed care organizations are actively exploring partnerships with community organizations to further NMDOH impact. This evaluation provides evidence that these actions have validity and that these investments result in better health outcomes.”
While the results of the study are significant and important, Tsai said more research is needed on this topic.
“As with all studies, there were limitations,” Tsai said. “We did not randomize residents and we had a fairly small sample so we hope to do more rigorous studies in the future.”
Other researchers with the UTHealth Houston School of Public Health who contributed to the study’s findings are Suja Rajan, PhD; Chau Truong, MPH; Vanessa Schick, PhD; and Cecilia Ganduglia Cazaban, MD, DrPH.
Funding for the study was provided by the Episcopal Health Foundation and Prospera Housing Community Services.