Last year, the Robert Wood Johnson Foundation launched a joint initiative with Community Catalyst called the Value Advocacy Project (VAP). The project is supporting consumer health advocacy organizations in six states in their non-lobbying advocacy efforts to pursue local and state policy and health system changes that increase the value of health care by improving health outcomes and lowering health care costs, especially for populations that have disproportionately poor outcomes. Building on the Center for Consumer Engagement in Health Innovation’s recently released Consumer Policy Platform for Health System Transformation, we will be highlighting our state partners working on issues outlined in the policy platform and encouraging them to share how their work can translate to advocates’ efforts across the country.

The Pennsylvania Health Access Network (PHAN) is teaming up with Project H.O.M.E, the Housing Alliance of Pennsylvania and the Pennsylvania Health Law Project to address the rising costs among high utilizers in Medicaid through coordinated care in patient-centered medical homes and by providing supportive housing services in Pennsylvania. We recently launched our Housing as Health Campaign to advocate for a statewide approach to patient-centered medical homes for Medicaid beneficiaries with chronic conditions and urge the state to use Medicaid dollars to establish permanent supportive housing services for Pennsylvania’s vulnerable populations. 

As more and more individuals access health care through the Affordable Care Act and Pennsylvania’s newly expanded Medicaid program, it is imperative that we focus on how to reduce costs and improve health outcomes for Pennsylvania’s most vulnerable populations. Lack of coordinated care and access to services that promote health often result in underserved populations turning to costlier forms of treatment instead of continuing the correct path of treatment for chronic conditions. 

With the expansion of Medicaid eligibility on Jan. 1, 2015, many more Pennsylvanians who have experienced chronic homelessness and who live with chronic health conditions have been able to enroll in Medicaid. Pennsylvania’s health plans and providers have an important opportunity to learn about this population’s needs and improve the quality of care and health outcomes. Many new Medicaid beneficiaries in this population have health needs complicated by substance use disorders and challenges related to mental health, trauma and other issues.  

This project is bringing together health, housing and mental health experts and leveraging consumer involvement to urge state policymakers to develop and implement new approaches to health care for vulnerable Medicaid beneficiaries, including requesting federal approval for a waiver. Strategies include engaging the existing consumer advocacy community, raising public awareness, educating policymakers and state Medicaid officials about the need for health system transformation, and working with housing advocates to lift up the benefits to vulnerable Pennsylvanians of supportive housing services. 

A big focus of our work involves engaging consumers from vulnerable populations such as those with substance use disorders, individuals experiencing homelessness and those with chronic health conditions. Through this project community health organizers are working with these targeted populations to help engage them in the campaign. We will help them share their stories about accessing health care with policy makers and the media to advance consumer friendly principles and the need for supportive housing services. Already we had a consumer forum in Philadelphia where three consumers shared their experiences with our patient-centered medical home advisory committee.

We hope our work will create a model for advocates in other states working to address both homelessness and communities with high health needs.

Antoinette Kraus, Director, Pennsylvania Health Access Network