The University of Illinois Hospital in Chicago has reduced healthcare costs by providing permanent housing for frequent ED utilizers with behavioral and medical issues who are homeless. •Patients are identified by ED staff as homeless, having one or more chronic disease, and substance abuse issues. •The Housing First model adapted by the hospital places patients in subsidized housing, then helps them with their problems. •The hospital has partnered with the Chicago Center for Housing and Health, which provides case managers to help participants navigate the healthcare system and teach them basic life skills.