Housing investment strategies by healthcare payers and systems: Paving the road ahead

Since passage of the Affordable Care Act, which both statutorily mandated tax-exempt health systems to address community needs and incentivized payers to invest in social determinants of health, a new era of investing in affordable housing has begun. CVS Health invested $185 million in affordable housing in 2021 while Kaiser Permanente topped its housing investment fund at $400 million in 2022, often strategically restricting investments to areas where it is the predominant healthcare operator. Health systems spent $1.6 billion on housing-focused interventions from 2017 to 2019.2 This funneling of healthcare dollars towards housing demands an understanding of the policy and financial levers used to invest in housing. Programmatic improvements to protect and improve patient well-being will provide policymakers a better understanding of which approach, if any, healthcare entities—in collaboration with government agencies and community-based organizations—should exploit to create housing and improve health.