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How Housing like JCHE’s Can Help Reduce Health Care Costs

Posted: May 13, 2013

It is abundantly clear that housing like JCHE’s can reduce health care use and costs.  The primary concerns to the Medicare/Medicaid budgets are the costs associated with hospitalization, rehospitalization, and premature nursing home placement.  More than a few health care dollars are wasted when patients (a.k.a. people) transfer from one setting to another, such as hospital to home or rehab, and then get readmitted to the hospital.  Rehospitalizations are very common and in many cases can be reduced or avoided by putting systems in place and including all the players in the plan to support someone in the community: physicians, discharge planners, visiting nurses, home health care, social workers…. and yes, housing staff like JCHEs’! 


People who have been hospitalized complain that their discharge instructions were confusing, too general, were told to them as they were coming out of sedation, or involved products or equipment that they didn’t know how to use.  In addition, perhaps the people were overwhelmed by their diagnoses; perhaps their primary care physicians weren’t kept in the loop by the hospital doctors; perhaps the people had little to no informal support at home; or perhaps they needed more education about managing the chronic disease with which they had been diagnosed.


We have to acknowledge and applaud the many individuals and organizations who are putting a lot of effort into improving our health care delivery system.  But many of those efforts, including Affordable Care Act initiatives, are based in health care settings.  NOT WHERE MOST PEOPLE LIVE!!!!  I’ve had conversations with those individuals who tell me that their focus is on hospitals and nursing homes.  Perhaps in the future, housing like JCHE’s will be on the radar, but not now.  Well it should be!  I’m not saying that big bucks are not spent, and could be saved with better systems to avoid hospitalization, rehospitalization, rehab and nursing home stays in medical settings.  I just think housing plays an important role and should not be left out of the equation.  Insurance companies (Medicare, Medicaid, private insurers) use a medical model, but seem to forget that for all the hours a day someone is not in a doctor's office, or the number of days per year someone is not in the hospital.... they are with us! 


Resident Services Coordination

Given how often doctors see their patients, how will they notice that an individual is looking or acting differently than they regularly do?  Good resident service coordinators (RSC) notice differences in a resident’s behavior, dress, grooming…, sometimes subtle differences, from that resident’s “normal”.  RSC can visit the resident in her/his apartment to see if s/he could figure out what may be causing the difference.  For example, a JCHE resident was exhibiting “odd” behavior.  The RSC made an appointment to visit the resident and discovered that her medications were completely mixed up. The resident had been prescribed one pill she needed to cut in half and another that she was only supposed to take every other day.  The RSC made a few phone calls and helped the resident set up a better system to manage her medications correctly.   RSC and other housing staff can also help with the transition from hospital to home.  They can help ensure that home health or home care services are coordinated, that staff from various agencies arrives and delivers the prescribed service; arrange adaptive equipment or transportation to and from the follow-up appointments with the physician.  JCHE employs twelve resident services coordinators who do this incredibly important work.


JCHE has built an infrastructure over many years that helps address various needs.  Resident service coordination is just one way JCHE is helping people and reducing health care costs!


Caren Silverlieb is Director of Strategic Planning and Partnerships

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