Multilevel evaluation of the Massachusetts Medicaid Flexible Services program to address food and housing insecurity

Waiver implementation and understanding how Medicaid benefits may better meet member needs.Using a mixed methods approach, program data (collected during referral, enrollment, ongoing check-ins, and through invoices), participant surveys and interviews, and healthcare claims were leveraged to understand utilization, experiences, and impact, and qualitative interviews were conducted with staff from participating community-based organizations to understand program implementation and lessons learned.Results: Over 700 members were referred, and the majority of enrollees (n = 516) entered from a substance use residential programs, corrections, or foster care.The most frequent services received were housing navigation, monthly rent support, move-in support, and utility assistance.Average rent support totaled $10,245.The population with the highest total benefit utilization was individuals transitioning out of corrections.Staff interviews highlighted the importance of shared visions and expectations among stakeholders, program infrastructure, and staff training and support for successful implementation.Participant surveys and interviews revealed challenges and successes with program experiences and impacts on housing stability.Conclusion: Across the nation, Medicaid is stepping into the housing space to improve adverse health outcomes associated with housing insecurity.This pilot informs ongoing efforts to implement housing supports and build stronger cross-sector collaboration as part of Medicaid-covered benefits.