Download our new white paper for more information: Partnerships between CoCs & health care entities enhance coordinated care and lead to sustainable, successful outcomes for the homeless population.
More Continuums of Care (CoCs) are partnering with health systems to improve outcomes for people experiencing homelessness, while also expanding their funding and resources to serve even more people in their communities. This blog outlines why it’s increasingly important for CoCs to develop these relationships, and also identifies the collaboration strategies that are working today and the technology hurdles CoCs must overcome.
The U.S. Department of Housing and Urban Development (HUD) requires local CoCs to develop a “comprehensive crisis response system in each community [using] new and innovative types of system coordination.” This mandate is critical for decreasing homelessness, and also reducing the negative health impacts of homelessness. Housing, health, and overall well-being are all inextricably linked, and the numbers clearly demonstrate this dynamic:
- The homeless population in the United States is three times more likely to use the emergency department than the general public.1
- Nearly 75 percent of the inpatient stays of people experiencing homelessness start in the ED, compared to 50 percent of the general public.2
- According to the Corporation of Supportive Housing (CSH) and the National Health Care for the Homeless Council, people experiencing homelessness account for a significant portion of the five percent of people who contribute to 50 percent of all health care costs in the U.S.
- The 2-1-1 call reports on U.S. problems/needs from 2008-2014 all showed housing as the top reason a person sought assistance from 2-1-1 Contact Centers, ranging from 22-32 percent in each annual report. Housing ranked above all other top 16 reasons for calls, including food and meals, income support, mental health, and employment.
With the U.S. scrambling to overcome the ongoing challenge of ever-rising health care costs, we need build partnerships between CoCs and health systems to effectively treat the homeless population; decrease the disproportionate health care expenses associated with people experiencing homelessness; and alleviate some of the pressure placed on hospitals, insurers, and communities.
Time is critical. The homeless population is aging and becoming more susceptible to chronic diseases like COPD, diabetes, cardiovascular disease, and cognitive diseases, including dementia and Alzheimer’s. Providing supportive housing and social needs can save $9,000-30,000 in health care costs per person, per year.
Establishing new strategic partnerships between CoCs with health care providers can help create a material decline in health care costs, reduce emergency department admissions, and increase sustained positive outcomes for people experiencing homelessness. A few of the strategies that have already proven successful, with cases from Florida to California, are cited in the upcoming white paper:
- Partner with health systems to provide comprehensive care.
This example accounts for all social determinants of health (SDoH) — including housing and personal safety; utility payment assistance; nutrition; transportation; education and employment; family and community support; financial services; substance use treatment; and mental health and disability supports.
- Work with hospitals on discharge planning for people experiencing homelessness.
A coordinated effort can support a more successful transition to permanent supportive housing. Discharge planning may help mitigate health care incidents and associated costs.
- Extend coordinated entry health centers.
This can help prioritize people who most need assistance, including people who are chronically homeless. According to the Corporation for Supportive Housing (CSH), 1,159 health centers served 1.2 million people experiencing homelessness in 2015. Beyond hospitals, health center program grantees are viable partners who share a common mission with CoCs.
Technology is an essential element in fostering collaboration between providers and organizations across the entire care ecosystem. Technology can help in the development of:
- Effective data sharing between Homeless Management Information Systems (HMIS) and hospital EHRs. In the past, data privacy and primacy concerns from hospitals have slowed collaboration.
- Equitable partnerships. Historically, some partnerships with hospitals haven’t provided adequate funding for the nonprofit entity. WellSky is finding ways to use its experience in health care reimbursement to help CoCs understand the pain points of value-based care and negotiate win-win deals for their communities.
- CoC expertise with outcomes reporting. Many hospitals have built their own in-house social service departments to replicate the functions of a homeless network. However, hospitals are better served when they integrate with the organizations and people who understand homelessness best — the CoCs.
Increased collaboration between health care providers and CoCs can have incredible benefits for the people each organization serves, and now is the time to grow these important relationships.
For even more information, download this informative white paper: : Partnerships between CoCs & health care entities enhance coordinated care, lead to sustainable, and successful outcomes for the homeless population
1Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. Journal of the American Medical Association. 2001;285(2):200-6.
2Karaca Z (AHRQ), Wong H (AHRQ), Mutter R (AHRQ). Characteristics of Homeless and Non-Homeless Individuals Using Inpatient and Emergency Department Services, 2008. Statistical Brief #152. March 2013. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb152.pdf. Accessed August 8, 2017.