Housing (or the lack thereof) is one of the most instrumental social determinants of health, and UnitedHealth Group is addressing it in a program in Phoenix that shows promise for reducing Medicaid costs.
MyConnections was developed by Jeffrey Brenner, MD, who founded the Camden Coalition, a national model for addressing people with poorly managed and complex medical issues that result in large expenditures.
Brenner, now senior vice president for clinical redesign for United, set up the experiment in Phoenix using a pair of apartment buildings in a rough-and-tumble section of Phoenix, according to a recent story in Bloomberg Businessweek. The apartments were then given to 60 homeless Medicaid patients. United, as a Medicaid managed care company, doesn't get paid directly for the housing but expects to make money because the medical expenditures of the now-housed members of its Medicaid plan will decrease.
We featured United's efforts to provide housing in Phoenix in our July-August 2018 issue:
Here’s how it works for UHCCP [UnitedHealthcare Community Plan–Arizona]: The health plan got permission from Arizona’s Medicaid agency to use some of its restricted reserve funds to loan $22 million to CPLC [Chicanos Por La Causa] a huge, multifaceted social services and community development agency serving three Southwestern states. CPLC used the money to buy and renovate 500 affordable housing apartment units in Phoenix. Up to 100 of those units are available for UHCCP members who are homeless; those apartments are provided for free or at very low cost, such as $200 or $300 a month.
Other news outlets have reported that United is making affordable housing investments with several other organizations including Enterprise Community Investment, Greater Minnesota Housing Fund, and Affordable Equity Partners. According to Bloomberg, United, although comfortably profitable, has been under pressure to increase the margin of its Medicaid managed care plans that altogether have about six million members,
Bloomberg reported that Brenner and UnitedHealth are expanding MyConnections to 350 people in 30 markets by early 2020. If those 350 people remained homeless and living on the street, their healthcare would cost the company in excess of $17 million.
Brenner is an advocate of "housing first" policies that reverse programs and policies that made the provision of subsidized housing contingent upon adherence to treatment, usually in the context of substance abuse or mental health."