Elevance Health Medicaid plan improves housing stability for NV beneficiaries

Elevance Health’s Medicaid plan in Nevada helped improve housing stability through housing interventions and financial assistance, according to a report from the payer.

Housing instability, such as experiencing homelessness or being at risk for homelessness, can lead to long-term mental health disorders and chronic conditions, affect nutrition and sleep, and hinder access to healthcare. Low-income and underserved populations are disproportionately affected by housing instability and homelessness.

State Medicaid programs and managed care plans can help address these health-related social needs by implementing housing interventions and partnering with community organizations to connect beneficiaries with housing resources.

Elevance Health’s affiliated Medicaid plan in Nevada offers several housing stabilization programs for beneficiaries, including a Housing Flex Fund and a Family Stabilization Program. The Housing Flex Fund provides one-time or short-term flexible financial assistance to beneficiaries experiencing housing instability or homelessness. The Family Stabilization Program partners with a community-based housing assistance organization to offer housing support services and financial assistance to households with children.

The report assesses the impact on housing stability for beneficiaries who received a housing intervention through either of the two programs at one point between March 2022 and February 2023. At least one person from the included households was enrolled in the Nevada health plan for at least six months prior to and six months after receiving the intervention.

The analysis included 42 households with at least one family member receiving a housing intervention. After excluding people who were not enrolled in the Medicaid plan six months before and after receiving an intervention, there were 39 adults and 48 children. Among the 87 individuals, 37 were at risk for homelessness and 50 were experiencing homelessness before the housing intervention.

More than half (58.6 percent) of members in households who were experiencing housing instability and received a housing intervention were Black, while 18.4 percent were White, and 16.1 percent were Hispanic or Latino, highlighting racial disparities.

Hispanic or Latino and White beneficiaries account for 56.8 percent of the Nevada health plan’s Medicaid population but only made up 34.5 percent of beneficiaries experiencing housing instability. Meanwhile, Black beneficiaries comprise 28.7 percent of all health plan members and experienced housing instability at a higher rate.

Six months after the housing intervention, more than 90 percent of participating beneficiaries successfully remained in housing, including 57.5 percent of Black beneficiaries, 20.0 percent of White individuals, and 17.5 percent of Hispanic or Latino individuals. These results suggest minimal racial disparities in housing persisted after beneficiaries received a housing intervention.

There are several routes states can take when partnering with Medicaid managed care plans to provide housing support services. States are required to implement a managed care quality strategy, and they could choose to create quality initiatives that focus on improving housing stability.

In lieu of services (ILOS) provisions are optional and allow states to approve the substitution of services that are not generally covered under Medicaid. This could permit health plans to focus on initiatives addressing health-related social needs, like housing instability.

Additionally, states can amend the medical loss ratio rules in their managed care contracts to include more health-related social needs services in the numerator, providing plans with more flexibility to invest in housing support services.