Research-driven Solutions to Prevent and End Homelessness

June 10, 2026

Takeaway: This study showed that federal prevention solutions to homelessness, specifically VA's Supportive Services for Veteran Families (SSVF) initiative, were associated with improved health outcomes and lower inpatient costs. This can inform national policy debates regarding the best approaches to prevent and end homelessness within and beyond the VA healthcare system.

Background

According to the National Coalition for Homeless Veterans, 32,882 Veterans experienced homelessness in the United States in January 2024, of whom 13,851 were unsheltered.

Both numbers were historic lows, capping a 55% total decrease in Veteran homelessness since 2010; however, VA continues its efforts to eradicate housing instability among Veterans, which is associated with negative health outcomes and increased healthcare costs. The strongest predictor of being homeless after discharge from active duty is the presence of mental disorders (mental illness and/or substance use disorder).

Supportive Services for Veteran Families

VA's Supportive Services for Veteran Families (SSVF) is the nation's largest rapid rehousing and homelessness prevention program, serving both sheltered and unsheltered Veterans. The program offers primary prevention through homelessness prevention services for those at imminent risk, as well as rapid rehousing services for Veterans who are currently homeless. VA partners with community organizations (grantees) across the country in order to provide temporary financial assistance (TFA) to vulnerable Veterans through the SSVF program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who are homeless.

Led by HSR investigator Richard Nelson, PhD, this HSR-funded study sought to estimate the potential impacts of the SSVF program on mortality and healthcare cost outcomes over three years following entry into the program. Dr. Nelson and colleagues used an approach that included 693,383 patient-trials comprising 229,096 unique patients. The main outcomes were all-cause mortality and VA healthcare costs.

Veterans who enrolled in this hypothetical randomized controlled trial were assigned to either a treatment or control group. Veterans assigned to the treatment group would enroll in SSVF, with access to TFA, case management, and other services. Veterans assigned to the control group received usual care, which may have consisted of housing support services offered both in VA and the community.

SSVF's prevention services include:

• Crisis resolution to address the immediate risk of housing loss;
• Temporary financial assistance that covers rental and utility arrears and other housing-related expenses; and
• Case management that can assist Veterans in obtaining resources that will help achieve long-term housing stability.

Study Results and Implications

Study results showed that SSVF was associated with improved health outcomes and lower inpatient costs. These findings can inform national policy debates regarding the best approaches to prevent and end homelessness within and beyond VA. For example, in December 2022, the Centers for Medicare & Medicaid Services (CMS) announced that the Medicaid program would offer waivers to expand the tools available to individual states to address social determinants of health, including housing and food security. Further, study findings of an estimated 14% reduction in mortality risk associated with SSVF may have additional relevance because the mortality rate of unhoused individuals is 3 to 4 times higher than that in the general population.

Partners

VA's Supportive Services for Veteran Families (SSVF) and VA's National Center on Homelessness among Veterans (NCHAV).

Investigator

Richard Nelson, PhD, part of HSR's Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS).

Citation

Nelson R, Chapman A, Montgomery AE, et al. Healthcare outcomes of homelessness prevention programs in Veterans experiencing housing instability. JAMA Health Forum. January 23, 2026;7(1):e256417.