Innovative financing model aims to improve health and reduce healthcare spending
The New York Healthy Homes Collaborative (NYHHC) announced the launch of an innovative $4.75 million home-based asthma reduction project that will help hundreds of children and adults throughout New York City. This project will focus on addressing the underlying causes of asthma. This first of its kind project will use private sector investment to fund services through Affinity by Molina Healthcare. Medicaid savings will be used to provide full repayment to the transaction lenders, Northern Trust and the Green & Healthy Homes Initiative (GHHI).
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“Investment in this historic transaction will catalyze the healthcare sector by demonstrating that outcomes-based financing solutions can be a critical tool in addressing health disparities in this country,” said Ruth Ann Norton, President and CEO of GHHI. “This project captures the vision that funding health-based housing interventions to lower the incidence of asthma is critical to addressing the social determinants of health and equity. By taking these actions, we will not only show that healthy housing is healthcare, but that creating healthier home environments delivers significant and important healthcare cost savings.”
The project aims to reduce serious asthma episodes among 850 children and adults who have chronic asthma. The goal is to lower preventable healthcare usage and costs among participants, who all use Medicaid. Treating these issues early will not only improve the patients’ health and quality of life but will also increase school and work attendance.
“Asthma-related ER and hospital visits are often preventable,” said Jack Stephenson, Plan President at Molina Healthcare of New York. “Molina is excited to be a part of this innovative model designed to address and help remedy preventable hospitalizations while greatly improving our members’ quality of life.”
Helping people with asthma manage these issues earlier will reduce costs by preventing avoidable emergency department visits and hospitalizations. Estimates indicate that the project will result in $6.5 million in healthcare savings – which more than compensates for the initial investment.
“Northern Trust is committed to a social impact strategy designed to break down barriers and create more equitable opportunities and outcomes,” said Kimberly Evans, head of Corporate Sustainability, Inclusion, and Social Impact at Northern Trust. “We are pleased to support GHHI and NYHHC through our community investments as an innovative, sustainable way to improve the quality of life of children and adults suffering from asthma.”
The project’s goal is to establish sustainable Medicaid funding for preventive asthma services that address the social determinants of health through a model that is scalable and replicable. Northern Trust and GHHI, with funding support from The JPB Foundation, will provide $4.75 million in financing to pay for four years of project services. Using value-based payment contracts, Affinity by Molina Healthcare will repay the investment from cost savings that accrue to its Medicaid program from improvements in participants’ asthma outcomes.
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GHHI led the development of the project in partnership with Affinity by Molina Healthcare, AIRnyc, the Association for Energy Affordability (AEA), and Primary Care Development Corporation, with support from the New York City Department of Health and Mental Hygiene. Dorsey and Whitney LLP provided counsel for the transaction. Funding for the project development came from the Robert Wood Johnson Foundation and The JPB Foundation.
As COVID-19 continues to overwhelm our healthcare system and expose our nation’s glaring health and racial inequities, the NYHHC project aims to ease the burden on hospitals while providing relief to communities most impacted by the pandemic as well as by asthma. Black and Hispanic New Yorkers have up to six times more hospitalizations for asthma than their white peers. Most of this disparity is due to lack of access to high-quality, affordable care, including asthma self-management tools, remediation services to address asthma triggers in the home, and stable, healthy housing. In addition to increased asthma complications, poor housing conditions, food insecurity, and poverty have also been linked to higher incidence and mortality of COVID-19.
“Addressing social determinants—such as physical environment and external stressors—along with access to high-quality primary care, is essential to ensuring wellness, especially for communities fighting decades of disinvestment,” said Louise Cohen, CEO of Primary Care Development Corporation. “Reducing the frequency and severity of asthma episodes in high-incidence communities moves us one critical step closer to health equity for all New Yorkers. PCDC is happy to partner with the organizations and families involved to make the New York Healthy Homes Collaborative a success.”
AIRnyc and AEA will conduct project service delivery, which will include in-person and virtual home visits, asthma self-management education, and a range of evidenced-based environmental interventions to reduce in-home asthma triggers. The full range of the intervention services, which have shown to be effective in reducing the incidence of asthma, are currently not reimbursed by New York Medicaid.
“No child should ever be hospitalized for asthma,” said Shoshanah Brown, founder and CEO of AIRnyc. “It’s a common condition that we know how to manage when basic resources are in place, including but not limited to healthy housing, food security, and quality primary care. We are thrilled that this project will allow us to take a value-based, multi-sectoral approach to demonstrating what is possible when we invest in community-based programs that advance health equity.”
“Health and safety have always been a critical component of AEA’s energy efficiency services to low-income households, but this collaborative enables us to engage more deeply with building occupants to address asthma triggers in their homes,” said David Hepinstall, executive director of AEA. “This can enable households to better manage their health, reducing the need for emergency hospital care and improving educational and economic outcomes for families most in need.”
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