Housing for homeless patients could cut inappropriate ER use, readmissions

Hospitals should prioritize housing for homeless patients to prevent inappropriate emergency care and unnecessary readmissions, according to a Health Affairs blog post.

Patients without stable housing are far more likely to seek care in emergency rooms, have longer hospital stays and more frequent readmissions, write Kathy Moses and Rachel Davis, senior program officers at the Center for Health Care Strategies. They cite 2011 research that indicates that providing patients with housing improves outcomes and keeps them out of the hospital. Despite this research, there is less of a consensus on what specific strategies create these benefits, leading providers and organizations to test various approaches, they write.

Moses and Davis highlight the results of a collaborative pilot program in San Francisco to house San Francisco Health Plan's (SFHP) costliest homeless Medicaid patients. The program reserved one-third of the 172 units at the Kelly Cullen Community housing development for homeless SFHP beneficiaries with the highest needs and costs. The partners also provided ongoing care management, meeting patients in their homes, following a model similar to the "homeless navigators" other California programs used to help indigent patients after discharge and post-discharge respite care centers established in Texas.

Other programs have taken a different approach, incorporating support into local and state budgets, according to the blog post. For example, when New York Gov. Andrew Cuomo (D) assembled a team to control Empire State Medicaid costs, the experts identified homelessness as a major cost driver and recommended the state fund housing for high-risk, homeless Medicaid patients. In the last three years, the state has invested more than $260 million in new housing, rental subsidies and housing programs, coordinated across agencies such as the state Office of People with Developmental Disabilities, the AIDS Institute and the Office of Mental Health.

To learn more:
- here's the post