When San Francisco housed homeless, healthcare costs spiked--then plunged

When the city of San Francisco decided to provide housing for members of its homeless population, healthcare costs initially spiked--then dropped significantly, according to the San Francisco Chronicle.

The city shelled out $33.9 million for emergency care for some 1,800 homeless to whom it provided supportive housing between 2010 and 2012, a 199 percent increase during the first year of the experiment, the article said. Expenditures for behavioral health services also increased. But by the 2014-15 fiscal year, those costs plunged to $14 million. 

San Francisco is not the only city to embark on pilot programs to house the homeless. New York State has invested more than $260 million in recent years to provide housing to the homeless in order to cut down on the costs of serving its sizable Medicaid population.

In Portland, Oregon, a supportive housing program cut monthly healthcare costs for a cohort of 98 individuals, according to Forbes.com, although there were some cost spikes in the second year after they were housed.

Such steps should prove useful to hospitals, which in many instances face a quandary as to how to discharge homeless patients. They can face federal fines for merely putting them back on the street, and that also puts the homeless patients at higher risk of readmission. As a result, hospitals and healthcare systems in many cities have begun to experiment with discharging homeless patients into respite centers, giving social service agencies the opportunity to try and find housing for them.

But obstacles remain. In San Francisco, about half of the population that received supportive housing eventually left, likely because they were unable to keep up with rent payments based on their incomes, the article noted. 

To learn more:
- read the San Francisco Chronicle article (subscription may be required)
- check out the Forbes.com article