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Cost-Effectiveness of the Support and Services at Home (SASH) Program for Cardiovascular Risk Factors: A
Adam Atherly1, Casey Doerner2, Rong Yan1
1Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA.
Health Services Research
|March 11, 2026
Summary
The Support and Services at Home (SASH) program is a cost-effective intervention for improving cardiovascular health in older adults. This housing-based model reduces risk factors and enhances quality of life.
Area of Science:
- Gerontology
- Public Health
- Health Economics
Background:
- The Support and Services at Home (SASH) program integrates wellness, chronic disease management, and care coordination for older adults and individuals with disabilities.
- SASH operates within affordable housing, connecting participants with community-based services to prevent illness and manage health conditions.
Purpose of the Study:
- To evaluate the cost-effectiveness of the SASH program in improving health outcomes related to cardiovascular risk factors.
- To quantify the health gains and associated costs of the SASH program.
Main Methods:
- A Markov model was utilized to calculate total quality-adjusted life years (QALYs) gained from cardiovascular risk reduction.
- Program costs were analyzed using data from the SASH program in Vermont, collected between 2017 and 2023.
Main Results:
- SASH demonstrated effectiveness in reducing cardiovascular risk factors, including improved medication adherence and lower systolic blood pressure.
- The cost per QALY gained ranged from $4013 to $8344, varying by gender and diabetes status.
Conclusions:
- SASH presents a cost-effective strategy for enhancing the health of older adults and individuals with disabilities through community-based partnerships.
- Challenges in replicating and funding SASH, termed the "wrong pocket" problem, necessitate innovative approaches for integrating non-healthcare programs for improved system efficiency and equity.
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