With more than half of all affordable senior housing residents now enrolled in private Medicare Advantage plans, a new report from the federal government says that coordinated service and healthcare delivery could help those residents remain independent longer.
A study released last week by the departments of Housing and Urban Development and Health and Human Services looked at HUD-assisted households enrolled in Medicare Advantage plans and their demographic characteristics between 2018 and 2020.
Since 2020, MA enrollment has increased nationally and now has more enrollees than Medicare fee-for-service. For HUD-assisted older adults, MA enrollees increased 19% between 2018 and 2020. Of all HUD-assisted older adults, 96% were enrolled in Medicare in 2020, with 54% having MA coverage.
The report sought to better understand MA enrollment of adults receiving housing assistance from HUD’s three largest rental assistant programs: the Housing Choice Voucher program, public housing programs and multifamily programs. The findings highlight geographic concentrations of MA enrollees who received federal housing assistance.
The results, the authors wrote, create opportunities for private MA plans to partner with public housing agencies and HUD-assisted properties to improve the delivery of care and supportive services for enrollees, particularly older adults living in public and assisted housing.
In 2020, among individuals receiving federal housing assistance who had MA coverage, 6% lived in Section 202 Supportive Housing for the Elderly properties, almost one-third lived in project-based Section 8 buildings, and 0.6% lived in Section 811 properties for individuals living with disabilities.
But among all HUD programs, Section 202 (57%) and Section 811 (22%) had the largest percentage of individuals participating in each program who were enrolled in MA, even though those programs serve fewer people than other HUD programs.
In addition, in 2020, roughly 40% of individuals receiving federal housing assistance with MA coverage lived in five states: California, Florida, New York, Texas and Pennsylvania.
Compared with overall Medicare and MA populations, affordable senior housing residents enrolled in MA were more likely to have lower incomes, be dually eligible for Medicare and Medicaid, and identify as a person of color, according to the study. Those demographic factors also are associated with greater risk of adverse health outcomes, the report authors said.
Coordinated service delivery may help meet the needs of HUD-assisted adults at risk for adverse health outcomes and allow them to remain in an independent living setting as they age, according to the report.
The report looked at MA plan ownership and type, MA enrollees by HUD program, the geographic distribution of HUD-MA enrolled individuals, and opportunities presented by the geographic concentration of HUD-MA enrolled for care coordination and supportive services for at-risk populations.
