Housing is the Next Frontier in Proactive Care. Here’s How Health Plans Can Help

Maria had been living paycheck to paycheck for years, managing her type 2 diabetes as best she could. But when a stubborn infection turned into a serious complication – what the doctor at the ER called a “hyperglycemic crisis” – she found herself hospitalized for several weeks. Meanwhile, rent notices began to pile up outside her apartment door, and by the time she was discharged, her landlord had already started eviction proceedings. With no savings to cover moving costs, Maria began renting a storage unit for $100 to house her belongings while she stayed with friends and relatives. 

All the while, Maria was skipping her follow-up appointments to save for a new apartment. Her first instinct wasn’t to call her health plan to let them know she was about to lose her home. She wasn’t showing up on anyone’s radar as a housing security risk. She was just trying to get by. 

Maria is a fictional composite based on the real experiences of health plan members I’ve worked with over the years. Stories like hers are far more common than most healthcare organizations realize. People facing eviction, crushing rent burdens, or family instability rarely, if ever, announce it to their doctor or inform their health plan until they are already unhoused or at risk of homelessness. Research shows that people who lose their homes are far less likely to adhere to medication regimens, attend appointments, or manage their mental health conditions. By the time they find themselves facing housing insecurity, their health is already at risk.

The healthcare system is designed to respond to crises like these, not prevent them. Just as health plans have learned to identify and intervene early with chronic conditions like diabetes or heart disease, they can and should do the same for housing and other health-related social needs.

What’s at stake for health plans?

The risks that push people toward homelessness are predictable. In my role, I’ve worked with people who lost their housing after a relative died and their name wasn’t on the lease. Others had poor credit histories that prevented them from leasing apartments they could otherwise afford. Too often, the people I’ve worked with have spent months cycling in and out of inpatient psychiatric care and emergency rooms trying to get their needs met. Some have even returned home to an eviction notice – all because their illness kept them from paying rent. 

These are daily realities for thousands of people. But between health plan benefits, state and local programs, and community-based services, there are often plenty of safety nets available to prevent these realities from happening in the first place. 

This is where health plans have the power to make a real difference. Screening for housing insecurity should be as routine as checking blood pressure. When a member is paying a disproportionate share of their income for rent, relying on short-term storage units, or living informally with relatives, those are red flags. Without early intervention, these members will likely show up in the emergency department months later – not only burdened by health crises, but without a place to be safely discharged. Proactive screening can turn hidden risks into opportunities for intervention.

Screening alone, however, is just the beginning. Health plan members need access to real, flexible support after their risks have been identified. Today, too many resources are locked behind complex eligibility rules or buried in programs people only learn about by word of mouth. A member may qualify for a housing voucher outside of Section 8 without knowing it. They may be eligible to seal an eviction record under a new state law but lack the legal help to petition. They may even have secured an apartment but lack the funds to hire a moving truck, leaving them stuck in limbo. These are all solvable problems, with the right programming in place.

The evidence shows this approach works. Studies of supportive housing initiatives tied to Medicaid populations have consistently found reductions in ER visits and inpatient stays, along with lower healthcare costs overall. One recent analysis of a supportive housing program in Pennsylvania reported not only improved housing stability but significant declines in monthly Medicaid expenditures. 

For health plans focused on bending the cost curve, investing in housing stability is one of the most direct levers available. And the need is urgent – according to the Department of Housing and Urban Development, over 770,000 people experienced homelessness in 2024, an 18 percent increase from the year prior. When these individuals lose their homes, the downstream costs to the healthcare system escalate dramatically.

The path forward is clear. Health plans should integrate housing risk into their assessments, expand supports that bridge practical gaps, and partner with community organizations that connect members to resources in trusted, accessible settings. 

Housing must be treated the way we approach food insecurity or transportation – not as an afterthought, but as a core driver of health.

Photo credit: Lolon, Getty Images

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