When residents move into affordable housing, their health-care experiences change dramatically.

A new study reveals that Medicaid-covered residents had fewer emergency department visits, used more primary care, and accumulated lower medical expenditures compared with the year before they moved into affordable housing.

Researchers from the Center for Outcomes Research and Education (CORE) in partnership with Enterprise Community Partners, studied residents at 145 housing properties of three different types: family housing, permanent supportive housing (PSH), and housing for seniors and people with disabilities (SPD).

In one of the most striking findings, they found that total Medicaid costs fell 12% after people moved into affordable housing. Declines were seen in all housing types, with the largest drops seen at SPD (16%) and PSH (14%) properties.

A total of 1,625 qualifying individuals living in the 145 participating properties were included in the claims analysis. Medicaid costs for these individuals was $936,000 less in the year after they moved into affordable housing compared with the year before they moved in.

"The Health in Housing study holds national implications for health-care systems, payers, and policy makers looking for upstream solutions to address major health-care needs and fulfill reform goals," said Dr. Megan Sandel, associate professor of pediatrics at Boston University School of Medicine and a member of Enterprise’s board of trustees. "Housing with integrated health services is an important solution toward bending the health-care cost curve."

The report comes at a time when the affordable housing industry has been trying to use Medicaid and health-care funds to develop affordable housing.

The study findings suggest that affordable housing will likely drive down costs to the health-care system.

Health in Housing: Exploring the Intersection Between Housing and Health Care also found:

  • Outpatient primary-care use increased 20% while emergency department use fell by 18%;
  • Residents reported improved access to health services and quality of care, with about 40% saying it was better after move-in; and
  • Housing with integrated health services was a key driver of health-care outcomes, suggesting that increasing these services may result in even greater cost savings.


"Health reform has increasingly called upon health-care systems to recognize the importance of upstream factors that drive health outcomes and affect health-care costs. Our research shows that affordable housing is one of those key factors," said Bill Wright, Ph.D., director of CORE, and lead researcher on the study. "We live in a profoundly interconnected world, and we may be moving past the time when any sector can go it alone."