Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan's Permanent Supportive Housing Program

Sarah B. Hunter
Adam Scherling
Ryan K. McBain
Matthew Cefalu
Brian Briscombe
William Mcconnell
Priya Batra
December 2021


Study details permanent supportive housing program implementation and how this impacts outcomes and costs.


People experiencing homelessness often have chronic conditions and rely on emergency services for care. PSH programs can provide individuals with stable housing and supportive services to address their medical and social needs. This report evaluated outcomes for people experiencing homelessness before and after entering a PSH program operated by a Medicaid and Medicare managed care plan in Southern California, as compared to plan members not enrolled in the program. The report also describes program implementation and costs.


Participation in the PSH program was associated with more primary and home health care engagement and lower rates of inpatient and emergency care. However, the costs of the PSH program were not offset by decreased spending on health care services. The highest costs were incurred during the transitional period after program enrollment and before PSH placement. This suggests that decreasing the time between identification for program eligibility and housing placement may help reduce health care utilization when it is at its highest.


While this report did not show overall cost savings for a health plan-led PSH program, the benefits of these programs may require a longer time frame to observe. This report can help those planning PSH programs to better understand PSH program costs and implementation and develop appropriate outcome measures and goals.

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