A lot of health plans today are exploring or already investing in housing programs. That’s a good thing. But there’s a problem we keep seeing: people are trying to measure success in a way that doesn’t really reflect how housing works in the real world.
The most common approach is to look at it in black and white. Someone was unhoused when they started, now they’re housed. If that’s not the case, the program’s seen as a failure. But that kind of thinking is flawed from the start.
The reality is that housing instability sits on a spectrum. Some people are couch surfing. Some are in shelters. Some are living in encampments or cars. And each person’s situation is shaped by a unique mix of factors, mental health challenges, lack of income, missing documents, substance use, trauma, and so on. So when a program only tracks whether or not someone is housed, it’s missing the bigger picture.
In some cases, the program isn’t even built with the right starting point. You can’t just offer someone a housing placement and expect it to stick if they don’t have ID, or income, or the mental health support to live independently. That’s like trying to stop major bleeding with a Band-Aid, it might help a little, but it’s not solving the root issue.
We approach things differently. We don’t expect someone to jump from living on the street to a stable apartment overnight. That’s not how real life works. So we track progress instead of perfection.
Success might mean:
These might sound small, but they’re big steps on the path to stability. Every one of those milestones matters, and they’re all signs that someone is moving in the right direction.
Before you can even start talking about stable housing, you have to engage with people consistently, respectfully, and with trust. That’s why we’ve built our whole model around engagement. And because Upside started as a tech company, we’ve got the tools to track that engagement really closely.
We can see:
This helps us understand what’s working and where someone might be getting stuck. It also gives health plans better insight into how their members are being supported—something they often haven’t had from other partners.
Some health plans still say they’re waiting for more ROI data before moving forward with housing initiatives. I get that budgets are tight, and people want to make sure they’re investing in something that works.
But here’s the thing: the data already exists. Housing First programs have been studied for years. They consistently show strong outcomes, especially for people with high needs. The more complex the member, the higher the return.
We’ve worked with some of the most vulnerable people in some of the hardest places. And we’ve seen firsthand that this approach not only works, it works better when you take the time to meet people where they are and help them move forward, step by step.
If there’s one thing I’d encourage health plans to do, it’s to stop thinking of housing programs as pass/fail. Instead, ask: Are we helping people make progress? Are we building relationships that lead to stability? Are we capturing the full picture, not just the final outcome?
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