As the older adult population in the U.S. continues to grow, so does the number of older adults experiencing homelessness. By 2030, the number of adults over 65 who are experiencing homelessness is expected to triple. This population has a complex array of health and social needs. Adults in their 50s and 60s experiencing homelessness, for example, have rates of cognitive and functional impairment, falls, frailty, chronic medical conditions, and premature death similar to or higher than 80-year-old housed adults. With this comes high medical costs and frequent and unnecessary emergency department visits.

Permanent supportive housing ― a model that combines long-term housing, health care, and supportive services, including personal care and behavioral and physical health care management ― has shown promising results in reducing homelessness and emergency department visits and hospitalizations. Commonwealth Care Alliance (CCA), a non-profit community-based payer and provider serving people with significant needs, including those who are dually eligible for Medicaid and Medicare, partnered with Hearth, a non-profit community-based organization focused on ending elder homelessness, to provide permanent supportive housing for eligible CCA members. CCA provides a wide variety of services to their plan members, including primary care, long-term services and supports, behavioral health care, community paramedicine, crisis stabilization units, telehealth, transitional care, and assistance with social determinants of health. Hearth currently operates 228 units of permanent supportive housing in and around the Boston area and provides a multidisciplinary approach to meeting resident needs.