VA Supportive Services for Veteran Families Program Linked to Lower Mortality in Veterans

Key Takeaways

• Enrollment in the US Department of Veterans Affairs (VA) Supportive Services for Veteran Families (SSVF) program for veterans with housing instability was linked to a 13% lower risk of death over 3 years, indicating meaningful survival benefits compared with non-enrollment.
• The program shifted care patterns, with higher outpatient spending but significantly lower inpatient costs, suggesting improved care management and reduced reliance on expensive hospitalizations.
• Overall, SSVF was associated with better health outcomes and more efficient care use, without increasing total health care costs, highlighting its value as a supportive housing intervention.

Enrollment in the VA’s SSVF program is associated with lower mortality and a shift away from costly inpatient care over 3 years among veterans experiencing housing instability, according to a study published in JAMA Health Forum.

Researchers examined SSVF program, which provides case management, outreach, help accessing benefits, and temporary financial assistance for rent, utilities, security deposits, and other housing-related needs. Although prior studies had linked components of SSVF to better housing outcomes, lower health care costs, and improved health, this analysis specifically evaluated the program’s association with mortality and VA health care spending.

“Using data from the VA electronic health record, we identified veterans experiencing housing instability and constructed a series of target trial emulations evaluating the effect of SSVF on mortality and health care costs for 3 years following documentation of unstable housing,” explained the authors.

The final cohort included 693 383 patient-trials representing 229 096 unique veterans. Of these, 26 649 patient-trials (3.8%) involved enrollment in SSVF, while 666 734 were assigned to the comparison group. Veterans in the SSVF group had a mean age of 52.7 years and were 89.6% male; those in the no-SSVF group had a mean age of 53.8 years and were 90.8% male. Participants were followed for 3 years after the index date, and outcomes included mortality and VA health care costs.

After adjustment for baseline differences using inverse probability of treatment weighting, SSVF enrollment was associated with a 13% lower risk of death over 3 years compared with no SSVF enrollment (hazard ratio, 0.87; 95% CI, 0.82-0.92; P <.001). The program was also associated with significantly higher outpatient costs, which were $7534 greater over 3 years (95% CI, $6767-$8302), but significantly lower inpatient costs, which were reduced by $10 020 (95% CI, $6396-$13 644). There were no significant differences in emergency department, pharmacy, or total costs.

The largest cost differences appeared in the first year after enrollment, when outpatient spending was $4063 higher and inpatient spending was $4724 lower in the SSVF group.

“This cohort study using a target trial emulation approach found that SSVF was associated with improved health outcomes and with lowering inpatient costs,” concluded the study authors.

Reference

Nelson RE, Chapman AB, Montgomery AE, et al. Health care outcomes of homelessness prevention programs in veterans experiencing housing instability. JAMA Health Forum. 2026;7(1):e256417. doi:10.1001/jamahealthforum.2025.6417