Connecting Housing and Health Care

With our nation’s health care system entering a period of substantial change as the Affordable Care Act goes into effect, understanding the deep connection between housing and health care has never been more important.

This message was a major theme of the commission’s most recent public forum in Columbus, Ohio, where the issue of developing appropriate outcome measures for “service-enriched” housing was explored in depth.

It’s also the focus of an important new report prepared by consulting firm Health Management Associates (“HMA”) for Stewards of Affordable Housing for the Future (“SAHF”), a consortium of 12 not-for-profit housing providers that serve more than 96,000 low-income households throughout the United States.

The HMA report points out that affordable housing providers have a long track record of offering their residents secure and stable places to live. Assessing how this residential stability improves health outcomes and lowers costs for our nation’s health care system should be a priority of national policy.

Many housing providers also deliver health care and other vital support services to their residents in “service-enriched” environments. While these providers recognize the significant contribution they make to improved health care outcomes for their residents, these outcomes are often insufficiently measured and inadequately communicated to the broader health care system.

The successful integration of housing and health care will require the development of a business case for why it must be done, HMA’s Michael Nardone explained in Columbus. We need to work on getting housing to “speak the language” of health care and vice versa so we can both build a successful business case for stronger collaboration.

As the health care landscape changes, it will be doubly important for housing providers to understand what motivates the various stakeholders in the health care system. It’s also critical to articulate the “value proposition” of the support services provided by housing providers by demonstrating how they improve health and reduce costs.

The HMA report explains that one of the first steps that housing providers must take is to establish standard practices for capturing, collecting, and reporting data on current activities that impact residents’ health care status. For its part, SAHF is developing its own framework for evaluating the impact its member organizations are having on the health and wellness of their residents.

The federal government also has an important role to play in strengthening the partnerships between housing and health care providers. That’s why the commission recommends that HUD and HHS remove barriers preventing the creative use of residential platforms to meet health care needs as well as encourage health care providers to partner with their housing counterparts to create more integrated service delivery systems.

The commission also believes the evidence will show that service-enriched housing offers significant savings to the health care system. Congress and the Office of Management and Budget should take these savings into account, particularly when evaluating the costs of housing programs that serve frail seniors.

I want to commend SAHF not only for their wonderful work in providing affordable housing but also for their far-sighted leadership in bridging the divide between housing and health care. I am confident their pioneering work will reap rich rewards in the coming years.