Andy McMahon works for one of the preeminent insurance institutions in the country at United Health Care. At UHC, where McMahon is VP of Policy/Health and Human Services, he spends his days surveying the health landscape across the country — determining when it’s too risky to place a bet on someone’s health coverage, and when it makes sense.
The kind of power people like McMahon wield tends to evoke a suspicious eye from the public, especially populations in most desperate need of health coverage.
But on this clear mid-May day, McMahon surveys a different landscape—looking out from a stage at a crowd of over 150 people in Hartford, Connecticut, standing behind a podium at the historic Lyceum, home of the Partnership for Strong Communities.
McMahon’s talk is unlike ones generally expected from often vilified insurance companies. Instead, this talk is different, if not enlightening. McMahon addresses the crowd on ways UHC is working across the housing sector to ensure people are safely housed. He states in plain terms — stability is the first order in an individual being able to make the leap toward successfully treating their medical condition. It sounds like an almost strange sort of revelation.
The complexity of solving health issues, McMahon says, is directly correlated to whether people are living in stable conditions. If they are homeless, or unstably housed bouncing from place to place, they are worrying about survival, and not an acute or chronic health condition.
With this understanding, UHC has been investigating ways they can help increase the odds of health in individuals, and also the country, by creating better housing situations for people in need.
“People always talk about silos,” McMahon begins in regard to social sector issues and the desire to work more closely together. “But my question is, are we even on the same farm?”
More partnerships need to form states McMahon—across agencies, across state entities, HFA’s, housing providers, housing navigators, health and human services.
This advice seems contradictory to a for-profit insurance business to admit, so why would an insurance giant go through the trouble of championing the housing cause?
According to UHC, their involvement in affordable housing will increase the odds of health in people, and communities, and the good-will factor it provides to UHC is all it needs to form a competitive advantage in an industry that isn’t going away. It’s a win-win.
To accomplish this, UHC has reached across the housing sector to see how they can invest and promote affordable and supportive housing units. It starts with a multi-pronged and replicable approach, says McMahon.
• First, there are investments.
UHC has invested $400 million in Low Income Tax Credits since 2009.
• There are direct equity investments.
UHC has rehabbed over 500 units of affordable housing in Arizona, to help provide a safe and stable home for people most at risk of having health challenges.
• Then there are aggregated investments, where UHC starts a large fund, in the $50-$75 million range so they can fund the types of projects that apply and support affordable housing. The fund structure, McMahon cites, is preferable as it is much less challenging capacity-wise than building the product themselves.
• Next, there are very low interest loans that UHC provides to developers, in the 4-5% interest range, where the loans are paired with less-desirable 4% Low Income Tax Credits, to make those credits more attractive to developers to build affordable housing.
• Then there is the Pay For Success model UHC is involved in as the lead sponsor in Los Angeles where they put in nearly $7 million, and then the recapitalization of expiring affording housing stock, plus all the partner programs UTC has formed along the way.
Not long after listening to McMahon talk, one begins to realize that he and UHC are a different breed. They are looking out for humanity first and utilizing their wealth to get ahead of health issues with tangible solutions. Those tangible solutions? Housing as a fundamental assist to health.
Ultimately, what is the impact of housing on health?
McMahon introduces us to Joe. A 53-year-old male with 165 ER visits in 12 months, and over 50 hospital admissions. The cost of his healthcare was $385,000 in 2016-2017. When housed and provided proper supports, Joe was stabilized personally and health-wise, found work, and his costs reduced by over 10x.
“Housing matters,” McMahon rings home.
We agree. Not just for people, but for our communities, economies, and planet.
Panel Discussion Highlights on Health and Housing:
Victoria Veltri, JD, Executive Director, State of Connective, Office of Health Strategy:
“…The idea here is to recognize housing as healthcare. Everything is healthcare. Everyone must be in the same boat, we have to look to communities to work together. Local departments, health, housing agencies, hospitals in communities… I hope to partner with everyone in the room around this initiative and try to get to prevention. Right now, we have a sick system of healthcare, but we need to get to a health system of healthcare.”
Yvette Highsmith-Francis, MS, Vice President, Community Health Center, Inc. Eastern Region:
“… Healthcare happens where people live, and we need appropriate partners to address health holistically…. Not just in a doctor’s office, or dental chair… We must do something. Instead of help people with health then housing, we want to house people then help them… Six people we focused on were homeless and after being housed made significant healthcare improvements… Start somewhere. You eat an elephant one bite at a time.”
Lisa Bahadosingh, MS, Director of Youth Initiatives / Special Projects, Supportive Housing Works:
“Our partners include FQHC’s, criminal justice, substance use providers, medical providers, homeless outreach teams. Often the goal is to create a care plan for folks brought to the table and then determine what barriers they are facing… The entire community is accountable for someone on their list. When they get to know people, they realize how important housing is...”
Jeanne Milstein, Director of Human Services, City of New London
The Mayor of new London was a firefighter and helped pull someone out of river who had overdosed on opioids. He decided then that something had to be done. They created a service modeled after CAN. Once there was an epidemic of K2 poisonings with 7-8 transports a day. Sometimes 3-4 of the same people transported in the same day. They started getting these people stable housing with the needed treatment, recovery supports… within 3 weeks the numbers went down 75% through peer led engagement. We hired 3 part-time recovery navigators at a total of 50 hours per week and were able to get 30 people into treatment in 4 weeks. We are committed to equitable access.”
Kelly Thompson, JD, Chief Executive Officer, Alliance for Living
We are working on stigma reduction that prevents people from accessing treatment. We want to teach people how to use the overdose measures at the point of overdose to save lives. Addiction and substance abuse disorders, it’s chemical not character. We need to stay connected in relationships, even if this week they don’t want care, the following week they might.
This event was generously sponsored by United Health Foundation, Melville Charitable Trust, Bank of America, Ensworth Charitable Foundation, CT DOH, and CT Housing Finance Authority
Policy Luncheon Recap:
As told by Moderator and Partnership COO, Terry Nowakowski
Immediately following the conclusion of the IForum was the Policy Luncheon, which invited a select group of influential figures tightly aligned to healthcare, including the morning’s speakers, to continue the conversation. Introductions were made around a table of approximately 20 folks as the Partnership continued to make good on its reputation as a convener of people and organizations across the state. Many ideas were discussed, and attendees generally concluded that CT has many opportunities open to them to help positively affect the health sector through housing interventions. The group agreed that they would like to bring these thoughts and ideas back to the Partnership’s Health & Housing Stability Workgroup which meets in June. At that meeting, the group will look at some of the strategies discussed and develop a “roadmap” for CT to achieve these goals. The enthusiasm of those at the table was contagious and we look forward to seeing where this conversation takes us!