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Medicaid utilization and spending among homeless adults in New Jersey: implications for Medicaid-funded tenancy support services

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TypeOfResource
Text
TitleInfo
Title
Medicaid utilization and spending among homeless adults in New Jersey: implications for Medicaid-funded tenancy support services
Name (type = corporate); (authority = RutgersOrg-School)
NamePart
School of Social Work
Genre (authority = RULIB-FS)
Article, Refereed
Genre (authority = NISO JAV)
Accepted Manuscript (AM)
Genre (authority = ExL-Esploro)
Accepted manuscript
Note (type = peerReview)
Peer reviewed
OriginInfo
DateCreated (encoding = w3cdtf); (qualifier = exact); (keyDate = yes)
2020
PhysicalDescription
InternetMediaType
application/pdf
Extent
1 online resource (34 pages)
Language
LanguageTerm (authority = ISO 639-3:2007); (type = text)
English
Subject (authority = local)
Topic
Medicaid
Subject (authority = local)
Topic
Homelessness
Subject (authority = local)
Topic
Health care utilization
Subject (authority = local)
Topic
Health expenditures
Abstract (type = abstract)
Context: There is growing interest in developing Medicaid-funded tenancy support services (TSS) for homeless populations due to greater enrollment of homeless persons following the Affordable Care Act (ACA) Medicaid expansion and an emerging body of evidence that such services can reduce avoidable healthcare spending.

Methods: Drawing on linked Homeless Management Information System and Medicaid claims and encounter data, this study describes the characteristics of adults who could be eligible for Medicaid TSS in New Jersey and compares their utilization and Medicaid spending patterns to matched non-homeless beneficiaries.

Findings: More than 8,400 adults are estimated to be eligible for Medicaid TSS benefits in 2016 including approximately 4,000 living in permanent supportive housing, 800 formally designated as "chronically homeless" according to federal guidelines, 1,300 who are likely to be eligible for chronically homeless designation, and over 2,000 who are at risk of becoming chronically homeless. The groups of homeless adults are disproportionately ages 30-64, male, and African American and suffer very high burdens of mental health and substance use disorders, including opioid-related conditions. Medicaid spending for beneficiaries who are potentially eligible for TSS is 10% ($1,362) to 27% ($5,727) more than non-homeless Medicaid beneficiaries matched on demographic and clinical characteristics. Hospital inpatient and emergency department utilization accounts for three fourths or more of "excess" Medicaid spending among the homeless groups.

Conclusions: The analysis identifies a large group of high-need Medicaid beneficiaries who could benefit from TSS and specific areas where Medicaid funding for TSS could potentially reduce avoidable Medicaid utilization and spending.
Name (type = personal)
NamePart (type = family)
Cantor
NamePart (type = given)
Joel C.
Affiliation
Center for State Health Policy, Rutgers University
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
Chakravarty
NamePart (type = given)
Sujoy
Affiliation
Center for State Health Policy, Rutgers University
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
Nova
NamePart (type = given)
Jose
Affiliation
Center for State Health Policy, Rutgers University
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
Kelly
NamePart (type = given)
Taiisa
Affiliation
Monarch Housing Associates
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
DeLia
NamePart (type = given)
Derek
Affiliation
Medstar Health Research Institute
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
Tiderington
NamePart (type = given)
Emmy
Affiliation
School of Social Work, Rutgers University
Role
RoleTerm (type = text); (authority = marcrt)
author
Name (type = personal)
NamePart (type = family)
Brown
NamePart (type = given)
Richard W.
Affiliation
Monarch Housing Associates
Role
RoleTerm (type = text); (authority = marcrt)
author
Extension
DescriptiveEvent
Type
Citation
DateTime (encoding = w3cdtf)
2020
AssociatedObject
Type
Journal
Relationship
Has part
Name
The Milbank Quarterly
Identifier (type = volume and issue)
98(1)
Reference (type = url)
https://doi.org/10.1111/1468-0009.12446
Detail
106-130
RelatedItem (type = host)
TitleInfo
Title
Tiderington, Emmy
Identifier (type = local)
rucore30260400001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/t3-1nz7-vg51
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Copyright for scholarly resources published in RUcore is retained by the copyright holder. By virtue of its appearance in this open access medium, you are free to use this resource, with proper attribution, in educational and other non-commercial settings. Other uses, such as reproduction or republication, may require the permission of the copyright holder.
Copyright
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Copyright protected
Availability
Status
Open
Reason
Permission or license
RightsEvent
Type
Permission or license
AssociatedObject
Type
License
Name
Multiple author license v. 1
Detail
I hereby grant to Rutgers, The State University of New Jersey (Rutgers) the non-exclusive right to retain, reproduce, and distribute the deposited work (Work) in whole or in part, in and from its electronic format, without fee. This agreement does not represent a transfer of copyright to Rutgers.Rutgers may make and keep more than one copy of the Work for purposes of security, backup, preservation, and access and may migrate the Work to any medium or format for the purpose of preservation and access in the future. Rutgers will not make any alteration, other than as allowed by this agreement, to the Work.I represent and warrant to Rutgers that the Work is my original work. I also represent that the Work does not, to the best of my knowledge, infringe or violate any rights of others.I further represent and warrant that I have obtained all necessary rights to permit Rutgers to reproduce and distribute the Work and that any third-party owned content is clearly identified and acknowledged within the Work.By granting this license, I acknowledge that I have read and agreed to the terms of this agreement and all related RUcore and Rutgers policies.
RightsEvent
Type
Embargo
DateTime (point = start); (encoding = w3cdtf); (qualifier = exact)
2020-01-22
DateTime (point = end); (encoding = w3cdtf); (qualifier = exact)
2022-01-22
Detail
Access to this PDF has been restricted at the publisher's request. It will be publicly available after January 22, 2022.
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ContentModel
Document
CreatingApplication
DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2019-08-05T20:32:00
DateCreated (point = end); (encoding = w3cdtf); (qualifier = exact)
2019-08-05T20:33:00
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Microsoft Office Word
Version
16.0000
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