Evaluation of a collaborative model between managed care and affordable housing on acute care costs

Am J Manag Care. 2024 Mar;30(3):133-138. doi: 10.37765/ajmc.2024.89514.

Abstract

Objectives: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services.

Study design: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group).

Methods: Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019.

Results: The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation.

Conclusions: These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cephalosporins*
  • Costs and Cost Analysis
  • Housing*
  • Humans
  • Managed Care Programs*
  • Medicaid
  • United States

Substances

  • MCO
  • Cephalosporins