Housing Stability Emerges as Healthcare's Next Frontier: How One Company is Bridging Two Industries

Healthcare insurers are discovering an unexpected ally in their mission to reduce costs: the real estate industry. At the forefront of this convergence, one company is turning housing stability into a powerful tool for improving health outcomes. Upside, led by founder and CEO Jake Rothstein, is creating a new paradigm at the intersection of housing and healthcare that could reshape how both industries approach housing stability.

“These are two massive industries – healthcare and real estate – and they’re both slow-moving, complex, and highly regulated,” explains Rothstein. “What we said is: how can we merge these two industries? How do we start getting the healthcare industry to talk about housing, and how do we start getting the housing industry to consider the impacts on healthcare?”

The company’s origin story is deeply personal, rooted in Rothstein’s experience with his aging grandparents. While working as a traveling sales representative, he watched his 82-year-old grandmother struggle to care for his grandfather, who was battling Alzheimer’s. “She would call me, ‘Hey Jake, can you come over and just sit with your grandfather for half an hour?'” Rothstein recalls. “She was still very social and mobile and active, and she would just need a break every once in a while.”

These regular calls for help revealed a complex web of challenges facing older adults and their caregivers. As his grandfather’s condition worsened, the family faced difficult decisions. They moved him into a senior living facility at $12,000 per month, leaving his grandmother alone in a two-story house she could neither afford nor navigate after a hip replacement. “The family gets together, and we’re like, we got to sell this house,” Rothstein explains. “This was our first kind of glimpse of housing instability.”

What started as a family’s struggle to find appropriate housing for an aging grandmother evolved into a deeper understanding of a widespread problem. Housing instability, Rothstein discovered, affects people across all demographics – from seniors aging out of their homes to working families one paycheck away from eviction.

Housing instability manifests in various ways that directly impact health outcomes. “There are other basic things that you may not think about, like inadequate HVAC,” notes a company executive. “We’ve experienced members that are just running their oven at 425 degrees to heat their house. If they haven’t changed an air filter, it causes breathing respiratory issues.”

Connecting Real Estate Supply with Healthcare Demand

Upside’s innovative approach leverages existing real estate infrastructure to address immediate housing needs. The company has built a national network of vetted third-party operators, creating real-time visibility into housing inventory for health insurers. With multifamily properties experiencing an average 40% annual turnover rate, Upside sees an opportunity to fill these vacancies with pre-qualified tenants while addressing critical housing needs.

Upside’s business model is straightforward: they connect health insurers’ members with available housing inventory, creating value for both property owners and healthcare providers. The company has built a platform that provides health insurers with real-time visibility into apartment availability, pricing, and floor plans across their network of vetted properties.

For property owners, Upside offers a steady stream of pre-qualified tenants, helping fill the turnover mentioned in multifamily properties. These aren’t typical referrals; they’re tenants backed by healthcare partners who have a vested interest in maintaining stable housing for their members.

“We pre-qualify these tenants for the operators we place them with,” Rothstein explains. “We get paid when these people are long-term, stably housed, so it’s in our best interest to ensure successful placements.”

The company works with properties across the spectrum, matching different tenant populations with appropriate housing options. Medicare Advantage members might be placed in Class A or B properties, while Medicaid members are matched with well-maintained Class B or C buildings. Their network includes everything from large national apartment operators to local landlords with small portfolios – even eight-unit buildings in rural communities, provided they meet Upside’s quality and safety standards.

The Healthcare Cost Connection

The business case for healthcare providers is compelling. Research has established that housing stability is a fundamental determinant of health equity, directly impacting various health metrics, including hospital admissions, length of stay, fall risks, and management of chronic conditions. Studies examining returns on investment in social determinants of health have demonstrated the financial viability of housing interventions, with programs showing positive returns up to 224%. These findings are reinforced by real-world implementations, where affordable housing programs have generated up to $1.92 in social return for every dollar invested in yearly operating costs.

“If you don’t know where you’re sleeping tomorrow night, you really don’t care about going to see your doctor,” Rothstein emphasizes, highlighting how housing stability can improve overall healthcare engagement and preventive care.

Looking Ahead

“2025 is going to be the year of action,” he predicts. “We’re going to be able to help millions of people across the country find stable housing and keep them stabilized.”

The company’s approach represents a significant shift in how both healthcare and real estate industries approach housing stability. By creating a bridge between these traditionally separate sectors, Upside is pioneering a model that could transform how we think about housing’s role in healthcare outcomes while providing real estate operators with a steady stream of qualified tenants.

For real estate operators interested in participating in this emerging segment, Upside offers a unique opportunity to tap into a new tenant pipeline while contributing to improved health outcomes in their communities. As healthcare providers increasingly recognize housing as a critical social determinant of health, this intersection of real estate and healthcare is likely to become an increasingly important market segment.