The Housing To Heath Care Evolution

Executive Briefing | by | July 27, 2017


Monica E. Oss
Monica E. Oss

The housing issue is one that vexes U.S. health and human service policy at many levels. Funding for housing assistance is not keeping pace with need (see Substantial Funding Boost Needed to Renew Housing Vouchers in 2017 and Spending Caps Curb Housing Funding).

And the link between the housing and health care is well-documented.

Housing insecurity and health care are locked in a continuous cycle, wherein poor health increases the likelihood of homelessness and housing instability – and homelessness increases poor health outcomes. The homeless population is more likely to have chronic conditions and has a lower life expectancy (see Housing is Health Care). Access to stable housing has been shown to actively reduce overall health care expenditures (Supportive Housing Lowers Overall Health Care Expenditures Among Formerly Homeless Population). Supportive housing has been the most common approach for the most at-risk populations, and often includes a combination of housing, health care, and supportive services (for a quick look at our work on the funding for this, check out For Supportive Housing, Creativity Required).

But these supported housing initiatives have largely been funded by government – and there are many examples:

  1. North Carolina Initiative Doubles Supportive Housing Capacity For People With SMI
  2. Connecticut Governor Malloy Announces Plan To Expand Housing For People With Intellectual Disabilities
  3. Boston Public Health Commission Launches Partnership To House Vulnerable Populations
  4. Most Oregon Medicaid CCOs Support At Least One Housing-Related Service
  5. Seattle Plans New Navigation Center & ‘Housing First’ Approach To Reduce Homelessness
  6. Portland-Based Central City Concern Announces Partners In ‘Housing Is Health’ Project
  7. Massachusetts Chronic Homelessness Pay-For-Success Initiative Reports Housing 250 In First Year
  8. California To Launch $2 Billion ‘Housing First’ Program For Homeless Individuals With Serious Mental Illness
  9. San Diego County Launches New Mental Health Services & Supportive Housing Plan For Homeless Services
  10. Boise Launches Two ‘Housing First’ Projects

But, that may be changing. UnitedHealth Group announced it is investing $14.6 million in a Michigan mixed-income 60-unit housing redevelopment project. The project will include 21 supportive housing units reserved for people who are homeless and/or diagnosed with mental illness (see UnitedHealth Group Invests $15 Million For Michigan Mixed Income Housing Development). UnitedHealthcare has committed $350 million to 56 housing developments in 14 states since 2011.

And on September 23, 2016, Central City Concern in Portland, Oregon, announced that six health care groups invested $21.5 million in its “Housing Is Health” – five of the organizations invested $4.0 million each (CareOregon, Kaiser Permanente Northwest, Legacy Health, Oregon Health & Science University (OHSU), and Providence Health & Services – Oregon) and Adventist Health Portland, contributed $1.5 million.

The “hard line” at the Centers for Medicare & Medicaid Services (CMS) about reimbursement using Medicaid funds for housing is an issue that we’re written about before – see Is Housing Health Care? and A Question Of Permanent Supportive Housing. And until that changes, we may find more health plans and health systems looking for how to make innovative investments in housing.

For more from the OPEN MINDS Industry Library on housing, check out these resources:

  1. Supported Housing In Action
  2. What Is “Housing First”?
  3. Is Supportive Housing Your Next Service Line?
  4. New York City Opens First 5 Of 90 Planned New Homeless Shelters
  5. Turning The Tide On Homelessness, Neighborhood By Neighborhood
  6. 25% Of Renters Spend Over Half Of Income On Housing
  7. Chambliss Center Creates Tennessee Transitional Housing For Foster Children Over 18
  8. New York State To Launch ‘Prison-To-Public Housing’ Pilot In Syracuse, Schenectady, & White Plains
  9. Transitional Living Program For Foster Youth Increased Housing Stability, Economic Well-Being

For more on adopting a new service line such as housing, join Richard Louis, OPEN MINDS Advisory Board Member on September 27 at The 2017 OPEN MINDS Executive Leadership Retreat for his session, “Diversifying Your Revenue Streams: How To Successfully Launch A New Service Line.”


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