Impact Of Housing Support Services For Medicaid Enrollees With Serious Mental Illness, Substance Use Disorder

Health Affairs January 1, 2026
Tyler Bruefach, Rahma S. Mkuu, Jaclyn M. Hall, Daniela Rivero-Mendoza, Peyton A. Lurk, Christina Vincent, Madison R. McCraney, Choeeta Chakrabarti, Kristen Erichsen, Christopher R. Cogle

Abstract

In 2019, pursuant to a Section 1115 waiver, Florida launched a Statewide Medicaid Managed Care housing assistance pilot to foster housing stability and reduce preventable health care use in adults with serious mental illness (SMI) or substance use disorder (SUD). We conducted a retrospective cohort study to examine the relationship between four housing support services provided in the pilot (transitional housing support, tenancy support, peer support, and crisis management) and health care use and health outcomes among 1,300 pilot enrollees during the period December 2017–June 2024. Transitional housing support services were associated with a 15 percent increase in emergency department (ED) visits. Tenancy support services were associated with 51 percent lower odds of all-cause mortality, and peer...

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