Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability

Area of Science:

• Health economics
• Public health interventions
• Veteran affairs

Background:

• The US Department of Veterans Affairs (VA) utilizes the Supportive Services for Veteran Families (SSVF) program to provide temporary financial assistance (TFA) to vulnerable veterans.
• The primary goal of TFA is to prevent or resolve homelessness by covering housing-related expenses.

Purpose of the Study:

• To evaluate the cost-effectiveness of the SSVF program with TFA compared to the program without TFA for veterans facing housing insecurity.

Main Methods:

• A Markov simulation model was employed to compare costs and housing outcomes for a hypothetical cohort of SSVF enrollees.
• The model incorporated data from published literature and internal VA data, with a 2-year time horizon and probabilistic sensitivity analyses.

Main Results:

• The SSVF program with TFA incurred higher costs ($35,814 vs $32,562) but yielded more quality-adjusted life-years (QALYs) (1.541 vs 1.398).
• The incremental cost-effectiveness ratio (ICER) was $22,676 per QALY, indicating TFA's cost-effectiveness at a willingness-to-pay threshold of $150,000 per QALY.
• TFA demonstrated cost-effectiveness in 89.7% of simulations for rapid rehousing and 88.0% for homelessness prevention.

Conclusions:

• Temporary financial assistance (TFA) is a cost-effective strategy for addressing veteran housing insecurity within the SSVF program.
• The findings suggest that TFA improves health benefits at a reasonable cost, supporting its use in veteran support services.
• Future research should explore the cost-effectiveness of nationwide housing interventions for specific veteran subpopulations.