Massachusetts ‘Housing-First’ Approach Wins Population Health Prize

March 20, 2018
On March 20, at the Population Health Colloquium in Philadelphia, the Massachusetts Housing and Shelter Alliance was named the winner of the 2018 Hearst Health Prize.

On March 20, at the Population Health Colloquium in Philadelphia, the Massachusetts Housing and Shelter Alliance was named the winner of the 2018 Hearst Health Prize.

This annual $100,000 award is given in recognition of an organization’s outstanding achievement in managing or improving health in the United States.

The Massachusetts organization’s Home and Healthy for Good program is a permanent supportive housing program addressing chronic homelessness, overutilization of acute care and emergency care by removing barriers to housing. Individuals are provided with their own home where they can maintain sobriety, find employment, and achieve other health and life goals. Tenants live in leased, independent apartments or shared living arrangements that are integrated into the community. They have access to a broad range of comprehensive, community-based services, including medical and mental health care, substance abuse treatment, case management, and vocational and life skills training.

In accepting the award, Joe Finn, the organization’s executive director, noted that chronically homeless individuals are in difficult situations, often dealing with substance use disorders or mental health problems that make it difficult for them to make it through compliance-based housing systems. “Healthcare without housing makes good care difficult if not possible,” he said. With a housing-first approach, people are better able to manage conditions. “We have found that to be true,” Finn said. “Quality of life can improve dramatically. We are committed to an evidence-based approach. That means working together in unique ways to measure results. We are part of a national movement to create more permanent supportive housing.”

Some of the results the program has measured:

• A 78 percent reduction in utilization of emergency services within the first six months of housing; there is an increased utilization of mainstream systems of preventive and primary care.

• Prior to entering the Home and Healthy for Good program, 29 percent of the participants were satisfied with their health. After housing, 63 percent of the participants reported satisfaction with health.

• Since its founding, 981 adults experiencing chronic homelessness have been placed in permanent housing across Massachusetts.

• A 66 percent of the total Home and Healthy for Good population is either still housed or left the program to move on to another type of permanent housing.

The award was presented by Gregory Dorn, M.D., M.P.H., president of Hearst Health, and David Nash, M.D., M.B.A., dean of the Jefferson College of Population Health, who is also one of the judges. 

There were two other finalists for the prize. The first was Cincinnati Children’s Hospital Medical Center. Its All Children Thrive (ACT) Learning Network is focused on Cincinnati’s 66,000 children and, in particular, the needs of the city’s highest risk children living in poverty. The population-based improvements are aimed at reducing infant mortality and days that children spend in the hospital, and ensuring that children thrive by being school-ready at age five and reading proficiently by the third grade. The measured effects of the program include:

• Fewer extreme preterm births and the fewest preterm deaths ever.

• Three years without an extreme preterm birth in one high-risk neighborhood (Avondale).

• An 18 percent reduction in Avondale inpatient bed days.

• Schools improved in passing grades on reading benchmark assessment from 43 percent to 61 percent.

The other finalist is the national Nurse-Family Partnership. The maternal and child health program changes outcomes for the most vulnerable moms and babies in poverty. Nurse-Family Partnership serves close to 33,000 first-time moms and their families. Nurse-Family Partnership provides each expectant mom with a personal nurse to help her have a healthy pregnancy, improve her child’s health and development, and set goals to become economically self-sufficient. Its impacts include:

• Nurse-Family Partnership clients show significantly lower incidence of preterm births. A recent study showed Nurse-Family Partnership moms had a decrease by 18 percent in preterm deliveries.

• According to a 2005 RAND Corporation study, every $1 invested in the highest-risk families participating in Nurse-Family Partnership returned $5.70.

The Hearst Health Prize applications were evaluated based on the program's population health impact or outcome, demonstrated by measurable improvement; use of evidence-based interventions and best practices to improve the quality of care; promotion of communication, collaboration and engagement; scalability and sustainability; and innovation. The finalists were the highest scoring in these criteria based on evaluation by a distinguished panel of judges.