The Denver Housing to Health (H2H) program leverages pay for success financing and other resources to provide supportive housing to people experiencing homelessness who have frequent interactions with the criminal legal system and emergency health care services. As part of the pay for success contract, the City of Denver will repay investors if the project meets its housing stability goals. This brief details the housing stability payment outcomes for the first 14 project quarters. See our project page for more on Denver’s H2H Pay for Success project.

Why This Matters

This project demonstrates the use of pay for success financing to scale supportive housing, an evidence-based intervention to end homelessness and break the cycle of criminal legal involvement and emergency health care utilization. After an upfront investment of more than $10 million in project funding, investors could see a return of about $1 million if the project meets expectations, and up to $4 million if it exceeds them. This project also provides long-term, rigorous evidence of the impact of supportive housing for residents with many unmet health care needs on other systems, including criminal justice and health care.

What We Found

The cumulative housing stability payment from the City of Denver is $2,192,768 for the first 14 project quarters (July 2022 to December 2025). As of December 2025:

• 153 participants met the housing stability payment requirements during the first 14 project quarters:
  • 135 participants were stably housed for one year or more
  • 18 participants had a planned exit, such as a move to a higher level of care or death
• 79 percent of participants remained in housing at the one-year milestone, and 70 percent remained at two years. Most unplanned exits happened one or two months after entering housing.

The jail day reduction outcome does not meet the threshold for payment for the first 14 project quarters. As of December 2025:

• Two years after randomization, the percentage difference between the mean jail days of the treated and control groups was -2.3 percent.
• Overall arrest rates for this population have dropped dramatically in the last five years, and additional context suggests the lack of impact on jail days could be the result of a broader systems change in Denver and not a reflection of the H2H program itself.

Participants in supportive housing receive more of the health care services they need and use fewer emergency services that drive high costs. As of December 2025:

• Two years after randomization to the H2H program, supportive housing participants are significantly more likely to be enrolled in Medicaid, have significantly fewer emergency department days and behavioral health withdrawal admissions, and have significantly more mental health outpatient visits and prescription fills.

How We Did It

All outcome payment calculations are specified in the H2H pay for success agreement and evaluation design. The housing stability payment calculation uses data on jail stays and supportive housing entries and exits. The jail day reduction payment calculation uses data on jail stays to measure the difference in the regression adjusted mean jail days of the treated and control groups in the two years after randomization and was estimated using a treatment-on-the-treated approach. The program's impact on Medicaid service utilization was estimated using Colorado Medicaid data and regression-adjusted models.