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Innovative integration of housing and health in Portland, Oregon

During a recent meeting of NHC’s Housing and Health Working Group in Portland, Oregon, group members learned of the exciting work in Oregon to integrate housing into that state’s focus on health in the state Medicaid program. As described by Enterprise Community Partners, one strategy to address the health and well-being of low-income Oregonians is to use the Flexible Funds Pilot program, which authorizes Medicaid funds to be used on non-clinic services in order to address social determinants of health. The program supports the health of individuals by offering services such as short-term rental assistance and security deposits to improve the housing stability with of Medicaid enrollees. The Center for Outcomes Research and Education (CORE) will evaluate the impact of this use of Medicaid funds on the health of enrollees. If found to be effective, the hope is that other states will work with the Centers for Medicare and Medicaid Services to seek more flexibility in using Medicaid funds to address social determinants of health. Other research by CORE has found that helping Medicaid enrollees access affordable housing has a significant, positive impact on their health.

Oregon is also experimenting with the use of Medicaid funds to support the use of traditional health workers who apply a deep understanding of the culture of their community and focus on health equity to their interactions patients and help them navigate the health care system and address the social determinants of their health.

Oregon’s use of Coordinated Care Organizations, health care provider networks that offer a comprehensive approach to health care and the flexibility to address social determinants of health, are another avenue used in the state to better address the complex health needs of low-income residents with an integrated approach to well-being.

Even as efforts to repeal or change the Affordable Care Act stall in Congress, states are still focused on how to create health systems that achieve better health outcomes at lower costs. Oregon’s strategy of integrating care and seeking flexibility in the kinds of services Medicaid can fund provide an example for how other states may be able to reform their health systems to serve low-income residents more effectively.

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