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Continuums of Care and health systems: Overcoming homelessness 

Webinar

Housing & health care: How CoCs can take the lead in bridging the gap


We will soon publish our white paper, “Partnerships between CoCs & Health Care Entities Enhance Coordinated Care, Lead to Sustainable, and Successful Outcomes for Homeless Population," to provide a comprehensive perspective on the topic. This is an introductory post in a series that focuses on one element of the overall issue.

More Continuums of Care (CoCs) are partnering with health systems to drive improved outcomes for those experiencing homelessness, while expanding their own funding and resources to achieve more in their communities. This brief describes why it is so urgent for CoCs to pursue these relationships, identifies strategies that are working today, and the technology hurdles that still need to be overcome.

The Department of Housing and Urban Development (HUD) requires local Continuums of Care (CoCs) to develop a “comprehensive crisis response system in each community [using] new and innovative types of system coordination.” The mandate is critical to not only decreasing homelessness, but to diminish the negative health impacts of it. Housing, health, and overall well-being are inextricably linked, and the numbers demonstrate the dynamic:

  • The homeless population in the United States is three times more likely to use the emergency department (ED) than the general public.1
  • Nearly 75 percent of the inpatient stays by those experiencing homelessness start in the ED, compared to 50% of the general public.2
  • According to the Corporation on Supportive Housing (CSH) and the National Healthcare for Homeless, 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, more than all of the other top 16 reasons for calls that include food & meals, income support, mental health, and employment.

With the United States scrambling to overcome the ongoing challenge of ever-rising health care costs, partnerships between CoCs and health systems are needed to effectively treat the homeless population; to decrease the disproportionate health care expenses associated with those experiencing homelessness; and relieve some of the burden 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 such as dementia and Alzheimer’s. Providing supportive housing and social needs can help save from $9,000-30,000 per person, per year.

More strategic partnerships between CoCs with health-related providers are needed to realize a material decline in health care costs, emergency department admissions, and an increase in sustained positive outcomes among those experiencing homelessness. A few of the strategies that have already proven successful, with some cases from Florida to California, are cited in the upcoming white paper:

  1. 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.
  2. Work with hospitals on discharge planning for those experiencing homelessness.
    A coordinated effort can lead to a more successful transition to permanent supportive housing. Discharge planning may help mitigate health care incidents and associated costs.
  3. Extend Coordinated Entry health centers.
    This can help prioritize people who most need assistance, such as those who are chronically homeless. According to the Corporation for Supportive Housing (CSH), 1,159 health centers served 1.2M people experiencing homelessness in 2015. Beyond hospitals, these health center program grantees are viable partners who share a common mission with CoCs.


Technology will play an important part in fostering collaboration between providers across the entire ecosystem. Specifically, WellSky believes technology can help in the development of:

  • Effective data sharing between HMIS systems and hospital EHRs. The privacy and primacy concerns hospitals hold about their data have slowed cooperation in the past. 
  • Equitable partnerships. Many efforts with hospitals do not provide adequate funding for the non-profit 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 that attempt to replicate the functions of a homeless network. WellSky believes hospitals are better served when they integrate with the people who understand homelessness the best — the CoCs. 

“Partnerships between CoCs & Health Care Entities Enhance Coordinated Care, Lead to Sustainable, and Successful Outcomes for Homeless Population” will be published later this month. Stay tuned!

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.

Revenue Cycle Management

Recorded Oct 23, 2018

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Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.


Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

About WellSky

WellSky is a technology company that delivers software and services to transform an ever-growing range of care services worldwide. We anticipate the needs of care providers and communities, empowering them with insights and solutions that support high quality, scalable, and personalized care. With our platforms and partnership, care providers can deliver their best while managing costs and resources, so both businesses and communities flourish.

Building on a history of excellence and a reputation for quality, WellSky empowers providers to provide exceptional care, improve operational efficiency, reduce cost, and meet the challenges of their rapidly changing industries. Learn more at WellSky.com.

About Us

About WellSky

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.

About WellSky

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.