Kaiser invests $200 million to fight homelessness

Kaiser Permanente is funneling $200 million into efforts to address housing instability. It's the first of a series of investments the system will make in community initiatives that address social determinants of health.

"Affordable housing will be a significant focus of Kaiser Permanente's impact-investing portfolio to generate housing stability and improve health outcomes," said Bernard J. Tyson, chairman and CEO of Kaiser Permanente. "We hope our commitment creates a broader national conversation on homelessness and encourages other companies to join us to advance economic, social and environmental conditions for health."

Kaiser's investment in addressing homelessness is the largest by a healthcare provider to date, but it is not the first. A number of the nation's health systems and hospitals are working to lower cases of housing insecurity. New York and California have used Medicaid dollars to support housing services. The CMS in 2015 approved use of Medicaid funds for that purpose.

More than 550,000 Americans experienced homelessness on a given night in 2017, according to a National Alliance to End Homelessness report. The homeless have little time to devote to managing their health and adhering to medications, which often leads to poorer outcomes.

A 2013 American Journal of Public Health study of healthcare utilization among 6,500 homeless individuals in Boston found hospitalization and emergency room costs were 3.8 times the rate of an average Medicaid recipient. Each person cost Medicaid more than $2,000 per day.

Initiatives like one started by the Chicago-based University of Illinois Hospital & Health Sciences system have lowered overall healthcare costs. A year after providing permanent housing to chronically homeless patients who were also frequent ER users, the program cut spending by 21% among 17 homeless patients that year.

Kaiser chose to address homelessness first because of the importance of stable housing in promoting healthy communities. The Oakland, Calif.-based integrated system is also part of the Mayors and CEOs for U.S. Housing Investment, a coalition of local government officials and business leaders working to advance key federal housing priorities. It includes the mayors of Alexandria, Va.; Baltimore; Charlotte, N.C.; Oakland; and Portland, Ore.

Dr. Bechara Choucair, Kaiser's chief community health officer, said over the next five years, Kaiser will invest in hyperlocal programs. Other projects and partners have not yet been identified, but it's expected food insecurity and economic development will be targeted.

"To improve the health of an entire community we must step beyond the four walls of our hospitals and medical offices to help those most in need," Choucair said.