Health Plan of San Mateo Housing Supports Pilot

The Health Plan of San Mateo launched the Community Care Settings Pilot to target housing support needs of members. The Health Plan invested in coordinating with two nonprofit organizations that specialized in affordable supportive housing and transitional case management as well as paying for a portion of housing services. The Pilot targeted three groups: 1) LTC residents that could return to the community with LTSS, 2) individuals in acute care or short-term rehab settings being recommended for LTC, and 3) those in the community at imminent risk of LTC.
The average per person per month cost of intervention by housing referral:
1) Assisted living = $1,860–$2,130,
2) Individual home support: $0–$400,
3) Affordable housing: $0–$400

The goal of the program was to target the housing support needs of its members with the objective of reducing institutionalization, improving quality of life, and reducing total costs of care.

The large majority of participants surveyed indicated that their quality of life was maintained or increased during the pilot and that they were satisfied with the program.

The average overall cost of care PMPM dropped 43% ($10,055 to $5,721) following the intervention. Over $6,000 PMPM was saved on LTC and SNF costs alone.
A total of $2.4 million in savings was accrued 6 months post-intervention. When accounting for $1 million in start-up costs, the total net savings was $1.4 million.
The estimated ROI was $1.57 in savings for every $1 invested.