Health Begins at Home: Why Housing Has Become a Strategic Priority for Managed Care

For decades, healthcare organizations have invested billions of dollars to improve clinical care. Yet one of the strongest predictors of health outcomes isn't found in hospitals or physicians' offices—it's whether someone has a stable place to live.

Picture a woman living with diabetes who misses routine appointments because she is moving between temporary housing situations. Keeping up with medications becomes more difficult. Follow-up care is inconsistent. Her condition worsens, and eventually she seeks care in the emergency department.

These situations are often viewed as housing challenges. In reality, they are healthcare challenges.

A whole-health approach recognizes that health depends on more than medical care. Factors such as stable housing, reliable transportation, access to nutritious food, and community support often influence whether individuals can successfully engage with care and maintain their health over time.

According to the U.S. Department of Housing and Urban Development's 2023 Annual Homelessness Assessment Report, more than 653,000 people experienced homelessness on a single night in 2023. At Elevance Health, internal analysis of affiliated Medicaid plan members with high healthcare utilization found that nearly half of members with more than 50 emergency department visits annually were experiencing homelessness.

The connection is clear. Without stable housing, managing chronic conditions becomes far more difficult. Medication adherence suffers. Follow-up care is missed. Behavioral health needs often intensify. Preventive care takes a back seat to immediate concerns about safety and shelter.

Housing Influences Nearly Every Outcome That Matters

The National Academy of Medicine has noted that medical care alone is insufficient to ensure better health outcomes, highlighting the significant influence that social, economic, and environmental factors have on health and well-being.

Housing may be among the most influential of those factors. According to Healthy People 2030, housing instability can make it harder to access healthcare, negatively affect physical health, and contribute to poorer outcomes across a range of populations.

For individuals living with chronic conditions, stable housing enables consistent care. Conversely, housing instability can disrupt care continuity, increase financial strain, and contribute to worsening physical and behavioral health outcomes.

Why Housing Has Become a Strategic Healthcare Investment

Historically, healthcare investments focused on expanding access to clinical services. While those investments remain essential, many organizations now realize that healthcare alone cannot overcome barriers created by unstable living conditions.

Across the healthcare industry, health plans, providers, and community organizations are increasingly recognizing that housing stability is a healthcare issue and an important component of long-term cost management. At Elevance Health, that commitment has translated into more than $1 billion in affordable housing investments over nearly two decades, supporting more than 40,000 housing units nationwide. Since 2021 alone, the company has invested $640 million, supporting the development of 2,654 affordable housing units across 10 states.

Our investments have reinforced an important reality: housing instability rarely exists in isolation. It often overlaps with behavioral health needs, food insecurity, transportation barriers, and social isolation. Addressing one challenge creates opportunities to address the others.

Importantly, these efforts are not simply about constructing housing units. They are about creating opportunities for individuals to establish stability, improve health outcomes, and access community resources that support long-term well-being.

One lesson has become increasingly clear: housing investments deliver the greatest value when paired with coordinated care. Stable housing creates the conditions for care managers, behavioral health providers, and community organizations to engage members consistently, making clinical interventions more effective and helping sustain long-term independence.

Through affiliated health plans, Elevance Health works with community partners to connect members to housing resources and services that help prevent homelessness and support long-term stability. Across multiple states, flexible housing support programs have assisted approximately 1,500 households by helping cover rent, utilities, security deposits, and other housing-related expenses.

Securing housing is only the first step. In select communities, housing efforts are paired with care coordination, behavioral health support, and connections to essential services.

Success depends on aligning incentives across sectors. Health plans can identify members with housing-related needs, community organizations can provide navigation and supportive services, housing developers can expand affordable inventory, and state agencies can create the policy flexibility that allows these efforts to scale.

The Opportunity for Managed Care

For managed care organizations, housing represents a unique opportunity because it intersects with several of the industry's most important priorities simultaneously.

It supports population health by addressing a key factor that influences health outcomes. It helps improve access and outcomes for populations facing significant health and social challenges. It contributes to lowering avoidable healthcare costs by addressing challenges before they result in costly interventions. And it strengthens community partnerships that are increasingly necessary to address complex health needs.

Housing is among the clearest examples of how healthcare organizations can connect clinical services with community-based support. In one state-based program supported through housing and community-based interventions, more than 90% of participating members maintained stable housing six months after receiving support. Results like these demonstrate what is possible when housing and healthcare strategies work together.

Looking Ahead

Clinical care remains indispensable, but the conditions in which people live, work, and age often determine whether that care achieves its intended impact. Stable housing provides a foundation upon which healthier lives can be built.

No single organization can solve the nation's housing challenges. However, healthcare organizations have an important role to play by partnering with communities, aligning investments with population health priorities, and recognizing that health begins long before someone enters a doctor's office.

As managed care continues to evolve toward whole-person care, the question is no longer whether housing belongs in healthcare strategy. The question is whether we can afford to leave it out.