The LTSS Center is working with Community Catalyst to explore new ways to serve older adults who are eligible for both Medicare and Medicaid.
The LeadingAge LTSS Center @UMass Boston and the Center for Consumer Engagement in Health Innovation at Community Catalyst are exploring potential opportunities for combining affordable senior housing with integrated care models, such as site-based features of the Program of All-Inclusive Care for the Elderly (PACE), to support vulnerable older adults with low incomes.
The 18-month project is supported by Arnold Ventures as part of its new Complex Care portfolio, with a strategic focus on improving care for Medicare-Medicaid beneficiaries. The portfolio’s aim is to:
- Increase integration between the Medicare and Medicaid programs so that individuals receive seamless, person-centered care.
- Increase the availability of integrated programs to Medicare-Medicaid beneficiaries across the country.
- Increase the flexibility of plans that serve these individuals to provide the services they need, be they medical, long-term support services, behavioral health, or social needs such as housing and nutrition.
BACKGROUND ON THE PROJECT
Researchers from the LTSS Center will work with the Center for Consumer Engagement in Health Innovation to explore new ways to serve individuals eligible for both Medicare and Medicaid who experience housing challenges.
In recent years, the dual eligible population has captured the attention of policy makers who see the potential to improve care for a group of beneficiaries that has greater health care needs and higher costs than individuals enrolled in Medicare or Medicaid alone. In particular, older adults with complex health needs face many challenges in finding affordable, accessible housing. There is a growing body of evidence supporting the effectiveness of combining housing with health care services to improve outcomes while reducing costs.
The interest of policy makers in serving dual eligible individuals has translated into a slate of recent policy proposals designed to expand integrated approaches to care, and increasing activity in both the public and private sectors to address the social needs of high-needs beneficiaries. This is an opportune moment to explore the next generation of integrated solutions to address both the housing and health care needs of low-income, frail older adults and people with disabilities.
PROJECT COMPONENTS
Researchers will conduct 3 primary activities as they assess the feasibility of bringing together integrated care models with affordable senior housing for dual eligible individuals.
- Policy analysis: This analysis will include a review of policy options for combining housing and integrated care models. Researchers will explore needed policy flexibilities in Medicare and Medicaid, and potential funding streams to provide housing subsidies and to stimulate development of affordable housing.
- Stakeholder analysis: Focus groups and key informant interviews will help researchers assess the interest of relevant stakeholders in a combined health care and housing model, and to identify features that would make this model workable and/or challenging.
- Market modeling: Finally, the research team will conduct an initial assessment of the market potential for an integrated model. That assessment will focus on a range of eligibility criteria.
FINAL REPORT
Research findings will be summarized in a final report that also will identify any key unresolved questions, sketch out features of a potential model, and put forward a roadmap for moving toward innovative new approaches to a combined housing and health care model. This report will be shared with key organizations in the health and housing arena, policy makers in Congress and at the Centers for Medicare and Medicaid Services, and the media.