Encouraging findings from intervention supporting unhoused patients

CCHE's evaluation of Samaritan finds enhanced patient support, cost savings

Samaritan, a digital health intervention designed to assist individuals at risk for or experiencing homelessness, showed promising results in a pilot evaluated by the Center for Community Health and Evaluation (CCHE), which is part of Kaiser Permanente Washington Health Research Institute. Notably, CCHE found that Samaritan benefited both the people experiencing homelessness who took part in the program as well as the health care system, which saw reduced costs.

Samaritan at a glance

Samaritan’s technology platform aims to help individuals experiencing homelessness (known as "Samaritan Members") set and achieve goals related to housing, income, health, and other essential needs. Care managers work with Members to break down these goals into actionable steps, identifying and addressing barriers along the way.

Members receive financial incentives for completing steps and upfront support to overcome immediate challenges. This support is provided by local community partners, volunteers, and individuals with lived experience.

In the pilot evaluated by CCHE, Samaritan was implemented in 5 community health centers in Los Angeles, and the work was supported by the California Health Care Foundation in collaboration with Health Care LA (an independent practice association) and California Hospital Medical Center.

Key findings

CCHE’s evaluation found that the health care costs for Samaritan Members during the 12 months after enrollment were less than half of those for a comparison group that wasn’t enrolled in the program. This cost reduction was driven by a decrease in emergency department use and hospitalizations, alongside an increase in preventive care, including greater use of primary care and specialist services.

Other key findings included:

• Members highly valued the financial incentives and community encouragement provided by Samaritan, which helped them stay motivated and achieve their goals.
• Participation in the program increased Members' confidence in meeting their social needs.
• Members expressed high satisfaction with their experience in the program, highlighting the importance of the support received.

 “The research here really showed us that social support became just as important as financial support — people counted on it,” said Melissa Trapp Petty, PhD, a manager at CCHE who was a lead evaluator of the program, along with Abby Isaacson and Xero Nazarova. “Our surveys found that those in the program felt like a part of their community, not like they are socially isolated and out there alone. They could achieve their personal goals — break their goals down into actionable steps, and walk through those steps until they get where they need to go.”

One partner testimonial stated: “There is so much inequity for unhoused patients. We tend to overlook them. By not only providing financial benefits but messages of encouragement, it really makes Samaritan special compared to other interventions. It's not just about financial incentives, but also about creating respect and value for this population.”

Trapp Petty noted that this quote highlights the unique and compassionate approach Samaritan takes toward addressing inequities faced by unhoused patients. “It goes beyond merely providing financial support, recognizing that messages of encouragement and respect can make a profound difference,” she said. “This dual focus on financial assistance and emotional uplift sets Samaritan apart from other interventions. By valuing and respecting unhoused individuals, the approach fosters a sense of worth and belonging that is often lacking in traditional programs, which tend to focus on material needs alone. This holistic model underscores the importance of dignity and empathy in care, making it a model for more inclusive and effective support systems.”

As Samaritan looks to expand its program in later phases, feedback from key leaders, care managers, and Members include numerous implementation recommendations focused on eligibility processes, service settings, resource preparedness, effective communication, and technical support.

“It’s easy to start seeing people as numbers, particularly in the context of densely populated, labyrinthine systems like health care and social health,” Nazarova said. “Personal engagement helps mitigate the risk of depersonalization of those within those systems, and I think that future projects examining how that element of personal engagement makes a huge difference in individual lives is a valuable direction to pursue.”