Medicaid is one of the major funding agencies for healthcare in the US which delivers health coverage to people with low incomes (Medicaid, n.d.). The Medicaid program was redesigned as per the instructions of Governor Andrew M. Cuomo on January 5, 2011 to address the deficit of budget (Department of Health, n.d.-b). A team was crafted in order to redesign the Medicaid program by the governor with the objective of developing a budget proposal for the first year and develop a reform plan. The key stakeholders of Medicaid were engaged to figure out the possible changes in the way of Medicaid spending with an emphasis on improving the quality. The triple aim of redesigning the Medicaid program was to improve care, improve health and reduce per capita costs (New York State Department of Health, n.d.). Medicaid was later divided into ten workgroups to cater the different requirements. These workgroups include the Supportive Housing Work Group, the Basic Benefit Review Work Group, the Behavioral Health Reform Work Group, the Health Disparities Work Group, the Health Systems Redesign: Brooklyn Work Group, the Managed Long Term Care Implementation and Waiver Redesign Work Group, the Medical Malpractice Reform Work Group, the Payment Reform and Quality Measurement Work Group, the Program Streamlining and State/Local Responsibilities Workgroup, the Social Determinants of Health Work Group, and the Workforce Flexibility and Change of Scope of Practice Work Group (Department of Health, n.d.-a).
A theory surfaced, for the first time, in 2013 which proposed that providing supportive housing to homeless people may be the answer to the issue of health and may show improvements. This theory projected the idea of cost saving, in hospital use and health care domains, through decreasing homelessness. It was later seen, in accordance with this theory, that New York assigned a $75 million budget for fiscal year 2012 – 2013. This was allocated from the state’s cut of supportive housing from Medicaid Redesign funding. This was provided to 4500 people from New York in the shape of newly built housing units and other services. Later, it was observed for the fiscal year 2013 – 2014, that an $86 million budget was allocated for the same (Doran, Misa, & Shah, 2013). The idea was clear and the researchers wanted to induce, rather observe, a decrease in health care costs for a family that was provided supportive housing after having been homeless for some time. The researchers explained that homelessness might be the cause, in some cases, of increasing health care costs and that is where this theory aimed at saving the costs for the state.
Studies have shown that health is connected to homelessness in most cases. One such study was conducted in 2007 that concluded that housing need was related to HIV medical care. The study focused on results from 5881 interviews during the period of 1994 to 2006. The sample was of 1661 persons with HIV/AIDS living in the New York City. A strong and consistent association was observed between the need for housing and HIV medical care (Aidala et al., n.d.). Another such study studied the impact of housing on health care costs. It was observed that the median monthly cost of health care reduced to $1492 and $598 per person per month after 6 and 12 months of housing, respectively, from a median cost of $4066 per person per month (Larimer, 2009). It was studies like these that forced an investment in working on reducing homelessness in the state of New York. These studies also show the potential impacts of funding the reduction of homelessness by providing housing solutions to the homeless.
Homelessness is something that results in other problems as well. The reduction of homelessness by funding supportive housing has the potential of rooting up other harmful effects from the society, especially in the health care sector. Funding initiatives taken by the Medicaid Redesign work groups may be the source of providing such facilities to the residents of New York and other states as well. These impacts are not only theoretical but they have also been proved by a number of studies conducted for this special purpose. The studies mentioned in this document may be viewed as examples of such studies. The impacts that these studies have proven in the reduction of health costs are incredible and have become the source of hope for the New York State. Other states might also take lesson from these examples and go for such initiatives. In fact, many states have already started to take such initiatives and change for the better.
Funding from the Medicaid Redesign Team to combat homelessness has positively impacted many families and individuals. One such example is of Mr. Peter Stabile who is now living in his own apartment in Long Island who was earlier homeless and unsure about his future. According to the supportive housing team, Peter exhibited signs of depression and anxiety when they first met them. Now, he feels great about his life and looks forward to a great future, thanks to the Medicaid Redesign team who provided the funding for supportive housing (York State Department of Health, n.d.).
Sochet explains that 1074 units have been financed by Medicaid Redesign funding which has provided housing for otherwise susceptible New York residents since 2012. Initiatives like the Creston Avenue residence have provided alternatives to vulnerable families and individuals to take on their lives with a better perspective and offered them a chance to do something better with their lives. These initiatives have, no doubt, a very positive effect on the lives of these families and individuals. These initiatives have transformed the lives of many individuals across the state of New York and are continuing to do so.
Doran et al. explaining the savings from funding healthcare through homelessness says, “The role of social determinants of health, and the business case for addressing them, is immediately clear when it comes to homelessness and housing. The 1.5 million Americans who experience homelessness in any given year face numerous health risks and are disproportionately represented among the highest users of costly hospital-based acute care”. He explains how the Medicaid Redesign funding has saved and will save even more of the costs for the American taxpayers.
Overall, it may be said that homelessness has been one of the major concerns and the center of consideration for Medicaid Redesign funding strategies and it has been seen as a barrier to healthcare, and studies exhibit the potential for savings in the healthcare costs if housing is provided to the homeless New Yorkers. Much research has targeted homelessness and its effects on the mental and physical health of people and a positive relationship was also observed in many of these studies. As a result, Medicaid Redesign team has invested its funding to reduce homelessness and has provided housing to many families and individuals across the New York. Examples of such families and individuals have also been discussed in this text. All in all, the research in the effects of homelessness to healthcare has benefited the homeless populace of New York and provided them with a number of housing opportunities and New York has seen a positive impact of Medicaid Redesign funding on homelessness.
Works Cited
Aidala, A. A., Gunjeong, A., Ae, L., Abramson, D. M., Messeri, P., & Siegler, A. (n.d.). Housing Need, Housing Assistance, and Connection to HIV Medical Care. https://doi.org/10.1007/s10461-007-9276-x
Doran, K. M., Misa, E. J., & Shah, N. R. (2013). Housing as Health Care — New York’s Boundary-Crossing Experiment. New England Journal of Medicine, 369(25), 2374–2377. https://doi.org/10.1056/NEJMp1310121
Larimer, M. E. (2009). Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems. Jama, 301(13), 1349. https://doi.org/10.1001/jama.2009.414
Medicaid. (n.d.). About Us. Retrieved January 4, 2017, from https://www.medicaid.gov/about-us/index.html
New York State Department of Health. (n.d.). Achieving the Triple Aim. Retrieved from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ny/Federal-State-Health-Reform-Partnership/ny-f-shrp-mrt-waiver-amend.pdf
Sochet, C. (2015). First Supportive Housing Development Financed with Medicaid Redesign Team Savings. Retrieved January 4, 2017, from http://rsequity.com/news/first-supportive-housing-development-financed-with-medicaid-redesign-team-savings
York State Department of Health, N. (n.d.). SUPPORTIVE HOUSING SPOTLIGHT Homeless to Housed in Long Island.
