Braiding Funds to House Complex Medicaid Beneficiaries: Key Policy Lessons from Louisiana
State health policymakers know that improving health and controlling costs sometimes requires investment outside the bounds of medical care. With support from the Robert Wood Johnson Foundation, this brief explores Louisiana’s permanent supportive housing program. The program, administered jointly by the state’s Medicaid agency and housing authority, is a cross-agency partnership that braids funding to serve vulnerable cross-disability populations, address homelessness, reduce institutionalization, and save money for the state. The state’s ability to sustain the program over time suggests that it holds lessons for other policymakers interested in combining funds to sustainably support initiatives addressing the social determinants of health.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
