title: Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing.
abstract: The provision of supportive housing is often recognized as important public policy, but it also plays a role in health care reform. Health care costs for the homeless reflect both their medical complexity and psychosocial risk factors. Supportive housing attempts to moderate both by providing stable places to live along with on-site integrated health services. In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. Together, these results indicate a potential association between supportive housing and reduced health care costs that warrants deeper consideration as part of ongoing health care reforms.
authors.affiliation: Bill J. Wright (bill.wright@providence.org) is regional director of the Center for Outcomes Research and Education at Providence Health and Services (CORE), in Portland, Oregon.
authors.forename: Bill J
authors.initials: BJ
authors.lastname: Wright
authors.affiliation: Keri B. Vartanian is an associate research scientist at CORE.
authors.forename: Keri B
authors.initials: KB
authors.lastname: Vartanian
authors.affiliation: Hsin-Fang Li is a research analyst at CORE.
authors.forename: Hsin-Fang
authors.initials: HF
authors.lastname: Li
authors.affiliation: Natalie Royal is a research associate at CORE.
authors.forename: Natalie
authors.initials: N
authors.lastname: Royal
authors.affiliation: Jennifer K. Matson is a project manager at CORE.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Matson
mesh_terms: D000293:Adolescent; D000328:Adult; D017046:Cost Savings; D005260:Female; D005102:Health Expenditures / Q000639:trends*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid / Q000191:economics; D008875:Middle Aged; D009922:Oregon; D010865:Pilot Projects; D011634:Public Health / Q000191:economics*; D011638:Public Housing / Q000191:economics* / Q000706:statistics & numerical data; D011788:Quality of Life; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Determinants Of Health; Disparities; Health Reform; Health Spending