Integration of Health Care and Housing Systems is Absolutely Essential

A key premise of the Bipartisan Policy Center’s report, Healthy Aging Begins at Home, is that a greater integration of American’s health care and housing systems will be absolutely essential to help manage chronic disease, improve health outcomes for seniors, and enable millions of American to age successfully in their own homes and communities. Research, tools, guides and education are available to support you in integrating health and housing in your community.

Socialization with family and friends is essential to healthy aging.

What You Need to Know

Does your state have counties with a population of 160,000 or more?

If so, the SASH model can reduce Medicare spending among your highest need, lowest income senior population. Inspired by the SASH model, HUD has launched the IWISH (Integrated Wellness in Supportive Housing) demonstration in 7 states at 40 locations.

Support And Services at Home (SASH) uses housing as a platform to improve health and reduce costs through a coordinated place-based approach that provides older residents, and persons with special needs, the supports needed to allow them to remain at home rather than requiring costly post-acute and institutional care. A dedicated two-person team works with primary care practices, hospitals and social service agencies to ensure that individuals residing in a designated housing site are afforded access to and utilize key health and social supports. A person-centered approach, uniform assessment, shared care plan, centralized database and use of evidence-based practices empowers participants to age how and where they choose.

Photo Courtesy of Cathedral

Courtesy of

Impact of SASH

SASH demonstrates a statistically significant reduction in the growth of Medicare spending and reduced hospitalizations. Best results were in the early cohort in Chittenden County with a population of 160,000 as compared to very rural counties.


Inspired by the SASH model, the Department of Housing & Urban Development has designed a three year demonstration, IWISH (Integrated Wellness in Supportive Housing). The demonstration is slated to end in September, 2020.

IWISH Trainings and Resources

Courtesy Saint Elizabeth Community

Saint Elizabeth Community

Saint Elizabeth Community was the first housing nonprofit in the country to replicate SASH. SEC intends to bring SASH to scale across RI which has 15,000 publicly assisted senior housing rental units. SEC’s first SASH site is The Place in Providence RI. A HUD Section 202 built in the early 1980’s, The Place has 149 apartments and is occupied by a largely Spanish-speaking population eligible for both Medicare and Medicaid. 

Get Involved

If you are committed to putting seniors in the driver’s seat and integrating where people live and their health care, please join the movement!