Medicaid-Financed Services in Supportive Housing for High-Need Homeless Beneficiaries

Medicaid expansion under the Affordable Care Act (ACA) will provide new insurance coverage to more individuals who are homeless. States could consider leveraging various Medicaid service options, i.e., health homes, to provide these new beneficiaries with care management services linked to supportive housing.

Medicaid-financed care management in supportive housing for high-risk homeless Medicaid beneficiaries could yield a significant return on investment from reduced hospitalizations and emergency department use. Growth in Medicaid managed care for these individuals, particularly after 2014, will expand opportunities to capitalize on care management linked to supportive housing with the prospect for sharing associated savings across providers, health plans, and states.

This brief outlines the rationale for states to consider designing Medicaid-financed, supportive housing-based care management services to improve care for at-risk beneficiaries while lowering costs associated with avoidable hospitalizations and other crisis services. The authors also raise considerations for policy-makers to address in designing strategies that use Medicaid resources to provide supportive housing-based services for people who are homeless.