Table 1.
Summary of challenges, opportunities, and recommendations for addressing housing insecurity
| Audience | Challenges | Opportunities and recommendations |
|---|---|---|
| Providers and practices | Limited information about social resources (eg, housing insecurity) available in medical records | Routinely and consistently screen patients for housing insecurity and connect with community resources |
| Participate in payment models and demonstration projects addressing social determinants of health | ||
| Develop standard process for tracking referrals | ||
| Develop and maintain formal inventory of a community’s available resources to address housing insecurity available in real time | ||
| Cancer centers | Limited cross-sector partnerships | Require providers to routinely screen patients for social needs |
| Create stable partnerships with community-based safety net organizations | ||
| Develop medical–legal partnerships | ||
| Participate in payment models and demonstration projects addressing social determinants of health | ||
| Support policies that address health equity | ||
| Support equitable enrollment of patients with cancer in clinical trials | ||
| Develop standard process for tracking referrals | ||
| Develop and maintain formal inventory of a community’s available resources to address housing insecurity available in real time | ||
| Payors and health systems | Limited payor–provider partnerships | Increase collaboration and interoperability across payors and providers |
| Lack of stable funding stream | Develop sustainable models for identification of patient housing needs and referral process | |
| Create standards for the reimbursement of social risk screening and related services | ||
| Reduce the financial toxicity of cancer treatment, which increases risk of housing insecurity | ||
| Professional societies and guideline developers | Lack of consistent standard professional guidelines | Establish consistent definition and concepts around housing insecurity across all sectors including health systems, communities, and housing services |
| Challenges of implementation | Create standardized data collection, aggregation, and sharing mechanism | |
| Create national standards for representing data related to patients’ housing situation in electronic health record systems | ||
| Health policy and housing policy | Inadequate infrastructure to integrate information systems and rules and regulations | Strong leadership and commitment from key stakeholders to making the collaboration across housing and health-care providers |
| Lack of access to stable, high-quality, affordable housing in well-resourced neighborhoods | Promote policies that address funding limitations in health and housing programs at a structural level | |
| Promote housing policies to ensure adequate and affordable housing for patients with cancer | ||
| Research funders and researchers | Limited evidence about prevalence, correlates, and associations with cancer care and outcomes | Identify scope of housing insecurity and variation by geography and other characteristics |
| Lack of rigorous study design | Evaluate association between housing and cancer care across continuum and outcomes | |
| Limited data infrastructure; need additional support | Assess reciprocal relationship between cancer diagnosis and housing insecurity | |
| Identify best practices for screening and connecting patients with identified needs to services and resources | ||
| Conduct rigorous research to evaluate the effectiveness of health-care system strategies, payment models, housing interventions, and policies using evidence-based approach | ||
| Assess optimal balance of spending among treatment needs, addressing housing needs of patients, and addressing upstream social determinants of health |