Housing Choice Voucher Prioritization Policies Impact Healthcare Utilization

Research published in the Journal of Urban Health, “Local Housing Choice Voucher Distribution Policies Impact Healthcare Utilization: a Randomized Natural Experiment,” tests whether prioritizing specific populations for Housing Choice Vouchers (HCVs) impacts healthcare utilization. The authors studied two housing authorities with different prioritization criteria for HCVs. Housing Authority A prioritized seniors, people enrolled in an education and employment program, and people with disabilities, while Housing Authority B distributed vouchers to medically complex individuals experiencing homelessness and families with school-aged children experiencing homelessness. Voucher recipients from Housing Authority A who found housing were 1.19 times more likely than waitlisted applicants to have at least one outpatient visit. Voucher recipients from Housing Authority B who found housing were 40% less likely than waitlisted applicants to visit an emergency department. 

Both housing authorities were demographically similar, were located on the West Coast, and used a random selection process to distribute vouchers. The authors compared healthcare utilization between applicants who found housing with an HCV to those who were waitlisted for a voucher. The authors restricted their sample to applicants who were enrolled in Medicaid for at least three months. The authors examined the healthcare visits made over one year. They categorized these visits as emergency department, inpatient, outpatient, outpatient mental health, or dental visits. 

Applicants who were selected for a voucher by Housing Authority A and who found housing were 1.19 times more likely than applicants still on the waitlist to have an outpatient appointment. The increase was mostly attributed to an increase in visits to a specialist. This outcome could be the result of an older applicant pool for Housing Authority A in need of specialized care. An increase in visits to specialists, therefore, is a positive outcome. Applicants who received a voucher from Housing Authority B and who found housing were 40% less likely than applicants still on the waiting list to have at least one emergency department visit. This finding supports other research that has found that people experiencing homelessness are more likely to rely on emergency departments for their healthcare – an expensive form of care.    

The authors encourage cross-sector collaboration to craft policies that integrate health and housing stability goals, such as investment by healthcare systems into brick-and-mortar housing. 

Read the report at: https://bit.ly/41SluD2