Addressing the Lack of Homes in Home Health

Access to home healthcare takes many forms. It can range from being able to afford quality care to being able to acquire and properly install home medical equipment. But what if someone isn’t in possession of a house?

According to the U.S. Department of Housing and Urban Development, more than 745,652 people experienced homelessness in 2025, reflecting housing challenges that communities face nationwide. For many, the lack of stable housing creates significant barriers to accessing care and managing their chronic health conditions.

Recently, Elevance Health (formerly Anthem), which operates Blue Cross and Blue Shield plans in more than a dozen states along with other Medicare, Medicaid and commercial insurance, announced it has invested approximately $640 million in affordable housing over the last five years, building on more than $1 billion the company had already invested over nearly two decades.

A Whole Health Approach

Adrienne McFadden, vice president and chief medical officer of Medicaid at Elevance, said the company chose to invest in housing as part of its “whole health” approach. When it came to analyzing challenges patients face with access to care, the organization’s team started to notice that the difficulties had little to do with what happened inside the doctor’s office and more to do with what happened after they left.

Over time, the company recognized that housing is one of the social determinants of health that can truly make a difference in how someone receives care. In McFadden’s words, housing truly is a healthcare issue and should be treated as such.

“For individuals that are managing chronic conditions or recovering from illnesses or injuries or receiving care at home, it’s really important that they have stable housing,” McFadden said. “…We know that having stable housing can determine whether or not they are able to follow a treatment plan as prescribed or keep their basic medical appointments, or even store their prescriptions that may need to be refrigerated or stored safely.”

Across its Medicaid plans, Elevance supports housing programs that address barriers such as past-due rent, utility costs and move-in expenses. Flexible funding programs also help members remain housed by covering essential needs such as security deposits, overdue rent and utility bills. Through these programs, patients can get assistance and resources that can help move them in the right direction.

McFadden said she sees these conversations as a “full circle moment” where more healthcare organizations are realizing stability is a key factor in patients fully benefiting from care they receive.

“I think, historically, healthcare has really focused primarily on delivering excellent clinical care, and rightly so,” McFadden said. “… And as the broader healthcare industry continues along the path of shifting towards whole person care or supporting community-based services in their efforts for supporting social determinants of health, or even in their efforts around advancing value-based care, the conversations about housing will likely become more commonplace because stable housing enables individuals to stay healthier, enables them to remain connected to care and avoid preventable utilization.”

Working Together

Looking to the future, McFadden said no single organization can solve the housing issue alone, but she believes there will be a much stronger collaboration amongst other entities like healthcare organizations, housing developers, home health providers and state agencies to work together as a team to create better environments for people to remain independent at home.

McFadden said independence can include access to healthcare and wellness programs, care coordination for individuals with complex needs, behavioral health support and connections to food, transportation and other essential services. McFadden said this collaborative effort makes at-home independence, whether it be recovering safely at home, managing chronic conditions or aging in place, more attainable. Elevance reported in one state-based program, more than 90% of participating members maintained stable housing six months after receiving support.

Addressing affordable housing is not a one-size-fits-all approach, according to McFadden. But organizations contributing resources that actually further whole health approaches for individual communities are helping those who previously couldn’t access what was needed to manage health conditions.

“It’s really about creating resilience in those communities and creating safe and stable housing for the individuals that call that community home,” she said. “…There are so many factors outside of the clinical space that influence health, like housing, transportation, nutrition, even the support available in the community. All of those play an important role in determining health outcomes, and we are truly committed to a whole health approach.”