Effects of Permanent Supportive Housing on Health Care Utilization and Spending Among New Jersey Medicaid Enrollees Experiencing Homelessness

Derek Delia
Jose Nova
Sujoy Chakravarty
Emmy Tiderington
Taiisa Kelly
Joel C. Cantor
Peer-Reviewed Article
April 2021


Permanent supportive housing (PSH) program reduced emergency department (ED) visits within the first six months of placement but showed neutral effects on total cost of care and primary care utilization for Medicaid enrollees.


PSH is housing with indefinite leasing or rental assistance paired with supportive services. PSH programs are funded through multiple sources, and some states such as New Jersey use Medicaid to fund tenancy support services for specific populations. This article evaluates the impact of PSH on health service utilization and linked Medicaid spending of 1,442 individuals in PSH programs compared with 6,064 homeless individuals not in PSH.


PSH was associated with a 14 percent reduction in ED visits and a 25 percent reduction in associated spending within the first six months of placement. However, there were neutral effects on total cost of care because of an increase in pharmaceutical spending, and also neutral effects on primary care utilization and spending.


Medicaid enrollees receiving PSH experienced reduced acute care utilization, suggesting that state investments in tenancy support services may help to support improved short-term outcomes.

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