Affordable Senior Housing HCBS

Report Explores Financing Options for Housing Plus Services Models

A new report from the LeadingAge LTSS Center @UMass Boston explores how Medicare and Medicaid funds might be used to finance delivery models that use affordable senior housing as a platform for coordinating health and supportive services to help older adults remain health and independent and reduce their use of costly health care services.

Exploring Financing Options for Services in Affordable Senior Housing Communities is based on a yearlong exploration conducted by staff from the LTSS Center, the National Well Home Network, and the Harvard Medical School Department of Health Care Policy. The Gordon and Betty Moore Foundation funded the exploration.

A detailed description of the exploration’s findings is included in a 35-page full report. An 8-page research snapshot provides an overview of the exploration and its findings.


The new report:

  • Describes the housing plus services model considered in the exploration, and the benefits associated with this model.
  • Defines criteria for considering potential financing sources.
  • Considers features of the housing plus services model that would be supported by potential financial sources.
  • Examines key issues that may bear on the feasibility of potential financing mechanisms for housing plus services models.
  • Discusses aspects of the Medicare and Medicaid programs that may facilitate or inhibit possible financial support of the model.
  • Presents and evaluates potential financing solutions that could make the housing plus services model feasible and sustainable.

Exploring Financing Options for Services in Affordable Senior Housing Communities is intended to inform housing providers, providers and payers of health care, and policy makers about the benefits of housing plus services options and the need to find sustainable funding strategies for these models.

Health providers will gain insights about the benefits of collaborating with providers of affordable senior housing to help patients address the social issues that are vital to maintaining or improving health.

Housing providers will gain a better understanding of how the Medicare and Medicaid regulatory, administrative, and practice frameworks could affect both a health entity’s ability to partner with housing providers to implement housing plus services models, and the health entity’s interest in such a partnership.

Policy makers will learn how housing plus services models could help advance health-related goals to improve quality of care and lower health care costs. They will also learn about challenges to spreading and sustaining these models and ideas for creating financing solutions.

Housing and health care entities will gain insights that will help them conduct more informed and productive conversations about potential partnerships.


Researchers conducted a literature review and interviewed expert stakeholders, including:

  • Representatives of managed care organizations and accountable care organizations.
  • Medicare and Medicaid policy experts.
  • Federal and state health policy officials.
  • Health care providers.
  • Affordable housing providers.

These stakeholders expressed great interest in and enthusiasm for affordable senior housing-based service coordination and wellness programs. They felt the most feasible approach in the near term would focus on the potential for collaboration between housing providers and Medicare managed care plans, including plans that support dual eligible individuals.

Stakeholders agreed on the need for more evidence to support a value proposition for the housing plus services model and to inform financing mechanisms.

They also emphasized the need to create greater awareness, among policy makers and executives of health systems and health plans, about the potential role that affordable senior housing communities could play as an efficient and effective platform for service coordination, early intervention, and prevention.

Source: LeadingAge LTSS Center @UMass Boston