In 2014, a partnership of nonprofit organizations came together in Portland, Oregon to form Housing with Services, LLC (HWS), a program to provide and coordinate services addressing the social determinants of health for low-income residents at eleven affordable housing communities serving low income seniors and adults with disabilities in downtown Portland. A previous evaluation in 2016 found that the HWS program improved access to some preventive services, but did not find evidence of short-term impacts on health care costs. This current study, conducted by the Center for Outcomes Research and Education (CORE), assessed the impact of HWS on six key health care utilization and cost outcomes, using a retrospective, pre-post comparative design with a control group composed of similar affordable housing communities that did not participate in HWS