Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices From the Field. 9. Conclusions


The past few years have been a time of great ferment in the health care world, with the next few years promising to see even more evolution and change. Medicaid is an important part of these changes, as states design and implement the coverage expansion aspects of the Affordable Care Act while also looking for ways to get better results from the health care delivery system and control the growth in Medicaid program costs.

For all the pressure for change, however, change comes very slowly for something as complex as health care, even as states, providers, and advocates try to be innovative and take bold steps. Medicaid is one of the most complex safety net programs, and this study's focus--how Medicaid is being and might be used to cover health-related costs for people with disabilities who have experienced chronic homelessness and need permanent housing with supportive services--is a small part of the Medicaid scene. It is, however, a very important element in the mix of assistance and supports that will help the United States end chronic homelessness, and in doing so, achieve savings in costs for avoidable hospitalizations, crisis care, and nursing home stays. This final chapter reflects on our findings and what they say about the role that Medicaid might play in the future in covering the mix of health, behavioral health, and supportive services that people need if they are to leave homelessness and improve their health status.

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