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The Role of Medicaid Managed Care in Increasing Permanent Supportive Housing Programs to Address Homelessness

Appell, Katherine (2021) The Role of Medicaid Managed Care in Increasing Permanent Supportive Housing Programs to Address Homelessness. Master Essay, University of Pittsburgh.

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People experiencing homelessness have high rates of chronic health conditions, behavioral health needs, and substance abuse disorder. Because of the transient nature of homelessness, preventive health care utilization is rare and expensive acute care is common. In addition, people experiencing homelessness are more likely to lack health insurance. This puts a strain on hospitals that care for uninsured individuals and people who have high readmission rates in hospital facilities. This problem was partially addressed by expanding Medicaid eligibility under the Affordable Care Act. With Medicaid coverage, people experiencing homelessness have greater access to preventative care and supportive services. In addition, Medicaid 1115 waivers provide housing related supportive services.

Originally designed to meet the needs of individuals with disabilities, Permanent Supportive Housing (PSH) is a best practice in addressing homelessness nationwide. Once housed, people receiving PSH care are offered a variety of physical, behavioral, and social support services that help establish independence and long-term stability. Finding funding for PSH can be challenging with policy barriers in government insurance funding allocation and social service funding that is stretched thin as is. Building sustainable funding streams and increasing focus in addressing homelessness through Permanent Supportive Housing is a necessary public health approach to address the severe personal and societal impacts of homelessness.

This essay will focus on addressing Pennsylvania homelessness through innovative Permanent Supportive Housing initiatives that are funded, in part, by Medicaid Managed Care Organizations. The essay aims to provide context on the impact of homelessness on the healthcare industry and in doing so outline best practice in providing supportive services to improve efficient utilization through various innovative funding mechanisms. To provide background information, the essay starts by examining evidence on the impacts of homelessness on health status and healthcare utilization. The essay then outlines the challenges in financing housing and supportive services for Medicaid enrollees. Overall, the essay looks to Permanent Supportive Housing as a gold standard in increasing efficient healthcare utilization and improving community health.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Appell, Katherinekea65@pitt.edukea65
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairDonohue, Juliejdonohue@pitt.edujdonohueUNSPECIFIED
Committee MemberElias, Thistleelias@pitt.edueliasUNSPECIFIED
Committee MemberLeiber, Saraleibers@ccbh.comUNSPECIFIEDUNSPECIFIED
Date: 10 May 2021
Date Type: Completion
Submission Date: 29 April 2021
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 47
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Medicaid, Managed Care Organization, Permanent Supportive Housing
Date Deposited: 10 May 2021 20:40
Last Modified: 10 May 2021 20:40


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