Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program.

Abstract

North Carolina Medicaid's Healthy Opportunities Pilots program is the country's first comprehensive program to evaluate the impact of paying community-based organizations to provide eligible Medicaid enrollees with an array of evidence-based services to address four domains of health-related social needs, one of which is housing. Using a mixed-methods approach, we mapped the distribution of severe housing problems and then examined the design and implementation of Healthy Opportunities Pilots housing services in the three program regions. Four cross-cutting implementation and policy themes emerged: accounting for variation in housing resources and needs to address housing insecurity, defining and pricing housing services in Medicaid, engaging diverse stakeholders across sectors to facilitate successful implementation, and developing sustainable financial models for delivery. The lessons learned and actionable insights can help inform the efforts of stakeholders elsewhere, particularly other state Medicaid programs, to design and implement cross-sectoral programs that address housing-related social needs by leveraging multiple policy-based resources. These lessons can also be useful for federal policy makers developing guidance on addressing housing-related needs in Medicaid.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1377/hlthaff.2023.01044

Publication Info

Huber, Katie, Raman Nohria, Vibhav Nandagiri, Rebecca Whitaker, Yolande Pokam Tchuisseu, Nicholas Pylypiw, Meaghan Dennison, Brianna Van Stekelenburg, et al. (2024). Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina's Healthy Opportunities Pilots Program. Health affairs (Project Hope), 43(2). pp. 190–199. 10.1377/hlthaff.2023.01044 Retrieved from https://hdl.handle.net/10161/30206.

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Scholars@Duke

Nohria

Raman Nohria

Assistant Professor in Family Medicine and Community Health

Raman Nohria, MD received his MD from the Lewis Katz School of Medicine at Temple University. He completed his residency training with the Lawrence Family Medicine Residency Program and hospital fellowship with the Duke Department of Family Medicine and Community Health. He currently serves as a teaching hospitalist on the Family Medicine Inpatient Service at Duke Regional Hospital as well as a core faculty member for the Duke Department of Family Medicine and Community Health. His expertise and scholarly interests include the social drivers of health, community-healthcare partnerships, and multi-stakeholder collaborations for health promotion and behavioral change.

Whitaker

Rebecca Garr Whitaker

Adjunct Assistant Professor in the Duke-Margolis Institute for Health Policy
Thoumi

Andrea Thoumi

Student

Andrea Thoumi, MPP, MSc is the Health Equity Policy Fellow and Core Faculty Member at the Duke-Margolis Center for Health Policy. In this capacity, she advances the Center’s aim to enhance policy analysis, research, and education in health equity.  Her research interests include health policies to mitigate structural and social determinants of health that lead to health inequities among Latine communities in the US and among people accessing reproductive health prevention, screening, and treatment. She also serves as an instructor on Bass Connections courses and is a research collaborator with the Latinx Advocacy Team & Interdisciplinary Network for COVID-19 (LATIN-19), Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP), and Women-Inspired Strategies for Healthcare (WISH). She is the recipient of AcademyHealth’s Disparities Interest Group Early-Stage Distinguished Investigator Award (2021) for her leadership, mentorship, and research and recipient of the Duke Presidential Award (2020) for exceptional service to the Duke community as a LATIN-19 team member.

Andrea combines expertise in health policy, health financing, health equity, and community health. Previously, she oversaw Duke-Margolis’s global health portfolio spanning value-based care, universal health coverage, primary health care, reproductive health and innovations to increase access to health services. Prior to Duke, Andrea was a Research Associate at the Brookings Institution, managing research on global accountable care and alternative payment models for oncology and diabetes. Previously, she worked as a Senior Analyst at Pricewaterhouse Coopers (PwC), conducting monitoring and evaluation for the Global Fund to Fight AIDS, Tuberculosis, and Malaria HIV/AIDS programs in Argentina and Belize. Andrea has also consulted for the Institute for Healthcare Improvement, Pan American Health Organization/World Health Organization, and the World Bank on health equity, financial protection, and health innovation. She holds a Master in Public Policy from Georgetown University, an MSc in Health Policy, Planning and Financing from the London School of Economics and the London School of Hygiene and Tropical Medicine, and BA in Community Health and International Relations from Tufts University.  

Lyn

Michelle Jacqueline Lyn

Assistant Professor in Family Medicine and Community Health

Population Health
Community Engagement and Capacity Building
Design and implementation of collaborative disease prevention/health promotion and health care delivery models
Design and implementation of care management models
Design and implementation of educational programs for health care professionals


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