Healthcare Company Offers Housing First as a Solution to High Costs

UnitedHealth Moving Some of Most Vulnerable Patients Experiencing Homelessness With Hope It Will Change Their Stories

As a society, we’ve effectively decided that people shouldn’t die on the street, but it’s acceptable for them to live there,” 

writes John Tozzi in a recent article in Bloomberg Businessweek. 

Much has been written recently about the connection between healthcare and homelessness, but this quote reminds us how as a society, we have come to accept homelessness. And sometimes, the homelessness crisis only makes the news when there is a tragedy involving someone experiencing homelessness.

In “America’s Largest Health Insurer Is Giving Apartments to Homeless People,” Tozzi gives the historical perspective of a 1986 federal law that mandates hospitals not to turn people away who cannot afford their care.

The article profiles Dr. Jeffery Brenner and his work for UnitedHealth to house indivdiuals experiencing homelessness who are the most frequent users of emergency department health care. United Health is housing 60 of its frequent users with affordable housing and support services in Arizona. These most vulnerable patients can cost companies like UnitedHealth the most money. Individuals with chronic illnesses experiencing homelessness cycle in and out of emergency departments in part because without a stable home, their illnesses are very difficult to manage.

The housing initiative was piloted in 3 communities and in 2020, will be expanded to 30 new areas. Brenner began his career practicing medicine in Camden, New Jersey where he saw firsthand the effect in our healthcare system that the low Medicaid reimbursement rates were having on expanding the need for more hospital beds.  Brenner founded the Camden Coalition of Healthcare Providers.  

“America’s outsize spending on health care contrasts with much paltrier investments in social support—housing, food, education, cash assistance, and care for children and the elderly. Other nations in the OECD spend $2 on social services for every $1 they spend on health care, according to The American Health Care Paradox, a 2013 book by Elizabeth Bradley and Lauren Taylor. In the U.S., each dollar of health spending is matched by only 60¢ of social support.”

The key to Brenner’s work at UnitedHealth is the Housing First model which gives indivdiuals experiencing homelessness a home first and then helps them address their mental illness or substance abuse. And case managers that help individuals keep their medical appointments help them maintain their healthcare which makes it easier to stay housed and address other chronic conditions.

The housing program costs United Health $1,200-$1,500/month for rent and the company wants to house individuals who they are spending $50,000/year on emergency department visits and inpatient hospital stays. It also wants to know that it is making a difference in the lives of these individuals.