Editor's note: This story was updated on March 21, 2018.
Dignity Health, Sutter Health, and other hospital systems around the country are increasingly investing in housing programs for homeless patients to curb ED overutilization and reduce health care costs, Pauline Bartolone writes for Kaiser Health News/Governing.
According to Bartolone, a 2002 study on homeless New York City residents with mental health issues found that providing such individuals with housing and support services significantly cut their use of hospital services, shelters, and correctional facilities. And while that research found that housing costs offset some of the savings generated by the program, a 2009 study of supportive housing services in Los Angeles found that individuals with consistent housing cost taxpayers 79 percent less than individuals who were homeless—and the majority of savings were in health care costs.
Still, a more recent Health Affairs study determined that it's hard to draw firm conclusions about whether such housing programs are cost effective because such initiatives frequently tend to be small, the methods of analysis vary widely, and the data are not always high-quality.
That said, Anthony Galace, director of health policy at Greenlining Institute in California, said such programs not only help individual recipients, but they "endea[r] [hospitals] to homelessness advocates." And according to Bartolone, the programs also enable not-for-profit health systems to meet their community service obligations.
Housing programs in action
According to the Corporation for Supportive Housing, a proponent and lender for homeless housing initiatives, hospital systems have invested between $75 million and $100 million in housing programs over the last several years. And in Oregon alone, five hospital systems in 2016 invested in a $21.5 million initiative to construct 400 units for homeless individuals.
Bartolone also spotlights Dignity, which in 2014 launched the "Housing with Dignity" program to house the patients received most frequently at its hospitals. The program began with an annual budget of $150,000 to house five clients at a time. Currently, the program uses financial assistance from insurer Health Net to provide housing for 12 formerly homeless individuals.
Ashley Brand, Dignity's director of community health and outreach, said the program doesn't aim to end homelessness, but rather to make sure that the homeless patients provided housing through the program receive follow-up health care services after they are discharged from the hospital. "Our hope is (that) dependency on the hospital services will be reduced," she said.
Meanwhile, after several years of funding smaller programs aimed at addressing homelessness, Sutter this year launched a $30 million initiative to end homelessness in Sacramento and two nearby counties in California. Keri Thomas, VP of external affairs for Sutter Health/Sacramento Valley Area, explained that while the health system could have "continue[d] to put dollars in again for programs that serve 200 people," there would always be 200 more the following year, unless the health system took a broader approach toward addressing the issue (Bartolone, Kaiser Health News/Governing, 10/12).
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