Homeless Service Use and Medicaid Spending in New Jersey

Individuals in NJ With Intersection of Homeless Service Use and Medicaid Use Have Higher Hospital and Pharmacy Use

On October 5, 2017, the 2017 Governor’s Conference on Housing and Economic Development featured a workshop on the Preliminary Findings on Homeless Service Use and Medicaid Spending in New Jersey.

Workshop presenters included:

Dr. Cantor presented about the research on Homeless Service Use and Medicaid Spending in New Jersey is funded by The Nicholson Foundation and the New Jersey Division of Medical Assistance and Health Services (DMHAS.)

The research found that the:

  • Top 0.1% of total Medicaid enrollment accounts for 7% of the spending,
  • Top 1.0% of Medicaid enrollment accounts for 28% of the spending, and
  • Top 5.0% of the Medicaid enrollment accounts for 62% of the spending.

The goals of the project are:

  • Link 2011-16 data from the Homeless Management Information System (HMIS) to the Medicaid Management Information System (HMIS).
  • Identify opportunities to generate Medicaid savings and improve patient outcomes among Medicaid beneficiaries who use homeless services.
  • Estimate the impact on Medicaid spending of permanent supportive housing placement.
  • Engage state officials and other interested stakeholders.

HMIS is a local information technology system used to collect client-level data and data on the provision of housing and services to homeless individuals and persons at risk of homelessness.

The average annual Medicaid spending by status in the Homelessness Management Information System (HMIS) was $6,694/year for individuals not in the HMIS system vs. $7,607/year for individuals in the HMIS system.

Comparing the composition of Medicaid spending by HMIS status, for individuals in the HMIS system, inpatient hospital spending was $1,622 vs. for individuals not in them HMIS system $950.

The summary of preliminary results of the research to date include:

  • About 8% of Medicaid beneficiaries appear in HMIS annually, 130,000-165,000 individuals, 20% increase after expansion
  • Medicaid beneficiaries appearing in HMIS are more likely to be ages 25-60 and less likely to be kids or 60+
  • Medicaid beneficiaries appearing in HMIS are much more likely to have substance use, substance use and mental health diagnoses, and serious mental illness
  • Medicaid beneficiaries appearing in HMIS have a higher inpatient and emergency department use
  • Medicaid beneficiaries appearing in HMIS have about 14% higher average Medicaid spending & more likely to be in higher spending group
  • Medicaid beneficiaries appearing in HMIS have higher hospital and pharmacy spending, lower LTC spending

Katelyn Cunningham and Paul Rossi of Foothold Technology presented a PowerPoint presentations and gave an overview of national research using HMIS and Medicaid.

Dr. Cantor’s PowerPoint

Monarch Housing PowerPoint

Foothold PowerPoint

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