Chronic Homelessness and High Users of Health Services: Report from a Meeting to Explore a Strategy for Reducing Medicaid Spending While Improving Care

There is evidence that homeless people, especially the chronically homeless, incur high health care costs, much of which may be paid for with Medicaid funds. There is also evidence that health care costs are reduced when homeless people with intensive medical needs enter supportive housing, which combines affordable, stable housing with care workers who assist residents in managing health, mental health, substance abuse, and employment issues. This evidence provides an opportunity for states to reduce Medicaid costs by increasing their investment in housing. In April 2007, a small group of homeless and housing advocates, state health care leaders, and managed care providers met to explore this opportunity. Meeting participants examined the experience of three supportive housing programs that have demonstrated a positive relationship between providing supportive housing to the chronically homeless, changes in health care utilization, and reductions in medical costs. Participants also identified opportunities for and barriers to the potential of supportive housing to reduce Medicaid costs.

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