The Client Challenge
Homelessness among Medicaid enrollees contributes to higher medical costs and higher rates of disenrollment from a lack of engagement. Facing an above-average homelessness rate among their nearly 1 million members, a managed care organization (MCO) decided to leverage housing programs to improve clinical and financial outcomes. The MCO partnered with Chartis to develop and execute a strategy to better manage members experiencing homelessness.
THE COST OF HOMELESSNESS
Higher medical costs
Limited access to preventive care
Reduced member and provider engagement
Increased member attrition
Poorer health outcomes
Navigating to Next: The Solution
Partnering with Chartis, the MCO aimed to quantify membership impacted by social barriers and build a roadmap for initiatives focused on removing those barriers. As part of the initial phase of a multi-year roadmap, the MCO sought to strengthen and optimize partnerships with community housing programs.
A key challenge of identifying the social barriers impacting members was insufficient data tracking around the social determinants of health (SDOH). We brought together the needed data by leveraging internal screening and medical history tools, Z codes from internal claims data, and external data, including that from the Homelessness Management Information System (HMIS). We also proposed a more proactive approach to ensure accurate member identification through homeless status coding in electronic health records (EHRs) to enable future identification. These efforts required both coordination among care managers, providers, and community organizations and back-end data management teams to enable clinical and financial outcomes tracking. As a result, the MCO developed a scalable model to grow its strategy from targeted interventions to enterprise member-centric value.