When we talk to health plan leaders about launching housing programs, the question that comes up almost immediately is:
“How would we even fund it?”
It’s a valid concern and one that often prevents good ideas from getting off the whiteboard.
The default assumption is that any housing investment has to come out of an administrative budget. And if that budget’s already spoken for, the opportunity gets delayed. Or dismissed.
But here’s the part that’s often missed: There are viable funding paths that don’t require waiting for a new fiscal year.
The truth is that housing, when implemented with the right population and model, can reduce high-cost medical utilization. Emergency room visits. Inpatient stays. Skilled nursing admissions. Etc.
Those outcomes aren’t just nice to have, they shift spend. This means they can often be categorized as medical costs, rather than administrative overhead.
That unlocks the ability to include housing-related investments within the Medical Loss Ratio (MLR), as 85% of spend plans are already required to allocate toward member care.
Too often, teams assume they don’t have the internal data or justification to support that shift. But with the right partners, it’s possible to tell that story. And once the finance and care management teams are aligned, it opens up far more flexibility than most realize.
Every plan is running dozens of programs, some that drive real results, and others that were designed as pilots, innovations, or supplemental benefits that no longer deliver value.
Rather than looking for new money, a better first question might be:
“Where are we already spending, but not seeing impact?”
Redirecting existing dollars toward high-need, high-impact populations, especially where housing instability is a known driver of poor outcomes, is often the most immediate and sustainable path forward.
This also aligns well with evolving federal and state funding mechanisms, particularly for complex populations like:
In many states, these groups already have pathways to enhanced funding, either through 1115 waivers or In Lieu of Services provisions.
One of the most common questions I get is:
“What’s the fastest path to funding a housing program that delivers impact?”
The honest answer? It depends. And that’s not a hedge, it’s a reflection of how nuanced this work is.
In some markets, like Minnesota, the path is already well-established through housing supports and network vendor programs. In others, like Nevada or Florida, we’re seeing newly approved Medicaid contracts and waivers that include housing components.
And in high-cost, high-utilization regions like Los Angeles County, the value of housing becomes self-evident because the downstream cost of not intervening is too high.
Our job is to meet each plan where they are. We help identify the population, the pain points, and the funding paths that make the most sense, whether that’s leveraging existing programs or building new ones that align with medical cost reduction goals.
Not every plan has the luxury of time. Some are dealing with immediate capacity issues in hospitals, rising medical costs, or pressure from state regulators.
For those situations, we’ve helped teams stand up programs without waiting on massive internal budget realignments.
I won’t share every detail here, but we’ve built quick-start models that allow plans to take action sooner, and we’re seeing real success with them across the country.
As a system, we’ve gotten better at treating illness. But not at preventing it. We’re extending lives, but often not improving them. Housing plays a critical role in changing that.
When someone is unstably housed, cycling through shelters, couch-surfing, living out of a car, it’s nearly impossible to manage chronic disease or stay on track with treatment. Stable housing becomes the foundation for everything that follows: better nutrition, stronger social connections, and improved health behaviors.
It’s not just a social need, it’s a strategic health investment.
If you’re a health plan leader thinking about launching a housing program but unsure where to start, we don’t come in with a one-size-fits-all answer. We start with your challenges, your populations, your goals, your constraints. And we work from there.
Sometimes the path is already in place. Other times, we help build it. But there’s almost always a way forward. The key is knowing where to look and having the proper support to get there.
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