Supportive housing as health care
Federally subsidized senior housing — HUD Section 202, Section 811, USDA Rural Development — is one of the largest under-utilized platforms for delivering preventive health care in the United States. This brief maps where the gap is worst and which states have activated Medicaid Housing Related Services (HRS) as a funding mechanism.
Why this matters
- Rural senior housing residents are, on average, further from hospitals, FQHCs, and specialty care than the general population.
- Chronic conditions (diabetes, heart disease, cognitive decline) cluster in these buildings at rates above state averages.
- Every avoided hospitalization saves Medicare/Medicaid $12,500 on average (AHRQ HCUP).
Medicaid Housing Related Services (HRS)
A growing number of states use 1115 waivers or state plan amendments to bill Medicaid for tenancy-sustaining and health-supportive services delivered in subsidized housing. See the individual state briefs for HRS status, billing entity, payment mechanism, and rate.