Prior research from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and U.S. Department of Housing and Urban Development (HUD) Office of Policy Development and Research (PD&R) show older adults receiving federal housing assistance face disproportionately high rates of chronic conditions and health care utilization. Coordinated delivery of services may help meet the needs of HUD-assisted adults and allow them to remain in an independent living setting as they age or their health worsens. HUD-assisted adults with Medicare Advantage (MA) coverage could potentially benefit from the care coordination and supplemental benefits offered by MA plans. However, prior to this project, HUD and ASPE did not understand the uptake of MA coverage among HUD-assisted persons.
This study sought to better understand MA enrollment among adults receiving housing assistance from HUD’s three largest rental assistance program categories: the Housing Choice Voucher program, public housing, and multifamily programs. To quantify MA coverage among HUD-assisted persons, the team merged HUD administrative data on public and assisted housing programs with Medicare enrollment and MA plan data from 2018 to 2020. Specifically, analysts deterministically linked person-level data from HUD’s annual longitudinal file with Medicare enrollee data from CMS’ Master Beneficiary Summary File (MBSF) using nine-digit social security number (SSN). In addition to quantifying MA enrollment among HUD-assisted persons, the study assessed the demographic characteristics and geographic distribution of this population.
Study findings highlight geographic concentrations of MA enrollees who receive federal housing assistance and opportunities to engage MA plans and housing stakeholders to improve delivery of care and supportive services for HUD-assisted persons, especially older adults living in public and assisted housing.
This research was conducted under contract #HHSP233201600022I between ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and the Lewin Group; with funding and support from HUD’s Office of Policy Development and Research. Additional research in this area is available at the ASPE Long-Term Services & Supports/Long-Term Care page and the ASPE Homelessness & Housing page.
Available Resources:
- Study report, infographic, and other materials can be accessed through HUD User at: https://huduser.gov/portal/publications/Medicare-Advantage-Coverage-Among-Individuals.html.