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Innovative Medical-Financial Partnership Between ESOP and MetroHealth

By Jeanne Hoban | | February 2020

LIFEPOP program helps patients improve their financial health

(Cleveland, OH) Empowering and Strengthening Ohio’s People (ESOP) and The MetroHealth System are partnering on a program to assist patients in their return to the community by helping them improve their financial health.

LIFEPOP, the Linking Financial Empowerment to Patient Outcomes Project, is an innovative Medical-Financial Partnership that embeds ESOP’s financial coaches at MetroHealth’s main campus and Old Brooklyn locations. The goal of the program is to positively impact the Social Determinants of Health for older adults, including their financial and housing stability. Research on the Social Determinants of Health has found that 40% of health outcomes are related to zip code rather than genetic code.

LIFEPOP is funded by The Cleveland Foundation and The Nord Family Foundation.

“Since 2014, ESOP has worked with over 20,000 older adult clients, many of whom on a daily basis have to make the difficult decision between buying food, purchasing essential medications and keeping utilities on” said Michael Billnitzer, Executive Director of ESOP. “With LIFEPOP we hope to improve the financial outcomes of MetroHealth’s older adult patients so they can meet their basic needs.

Through LIFEPOP, older adult patients referred to ESOP from the MetroHealth System will receive financial capability services.  240 will be participating in a research study. The Benjamin Rose Institute on Aging’s Center for Research and Education is overseeing the study to create a foundation for future randomized controlled studies that can establish a replicable, evidence-based program with the potential of being implemented in health settings across the country.

LIFEPOP clients will be referred to the program by inpatient and outpatient social workers and care coordinators.

“Over one in ten Cuyahoga County residents age 60 and older live in poverty” said Dr. James Misak, Medical Director of the MetroHealth System’s Institute for H.O.P.E.TM   “The inability of many of our community’s older adults to pay for their basic expenses threatens both their economic security and their health and well-being. We are hopeful that LIFEPOP will provide its participants a path to a more secure, healthier future while reducing their need for expensive emergency room visits and hospitalizations.”

LIFEPOP posits that receiving financial capability and housing stability services will improve patients’ medication adherence and lead to a decrease in emergency room visits and hospital readmission rates. This will enable older adults to age in place with greater financial stability. Promoting financial health should decrease systemic costs and bring about savings for Medicare and Medicaid, reducing expenses associated with long-term care if older adults can safely remain in their homes.


Empowering and Strengthening Ohio’s People (ESOP;, a HUD-approved Housing and Financial Counseling agency helps people in all stages of life achieve and maintain financial wellness and housing stability. Since 1993, the nonprofit HUD-certified agency has helped more than 55,000 homeowners across Ohio save their homes from foreclosure. ESOP is a subsidiary of Benjamin Rose Institute on Aging.

The MetroHealth System (, Cuyahoga County’s public health system, is honoring its commitment to create a healthier community by building a new hospital on its main campus in Cleveland. The building and the 25 acres of green space around it are catalyzing the revitalization of MetroHealth’s West Side neighborhood. MetroHealth broke ground on its new hospital in 2019. The project is being financed with nearly $1 billion the system borrowed on its own credit after dramatically improving its finances. In the past five years, MetroHealth’s operating revenue has increased by 40% and its number of employees by 21%. Today, its staff of 8,000 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. In the past year, MetroHealth has served 300,000 patients at more than 1.4 million visits in its hospitals and health centers, 75% of whom are uninsured or covered by Medicare or Medicaid.