Many states are likely to rely on managed care delivery and payment mechanisms as they expand coverage to people who are newly eligible for Medicaid. Medicaid managed care enrollment will likely keep expanding to include other groups of people with disabilities who are currently enrolled in Medicaid. This will make it increasingly important for PSH service-providers to establish contracts with MCOs so they can continue to get Medicaid reimbursement for the services they provide.
Some provisions of ACA may create opportunities for states to re-examine the separation between managed care arrangements for medical care and behavioral health care services and consider re-aligning delivery systems and payment mechanisms to support more integrated approaches to care.
MCOs are expected to play significant roles in the implementation of ACOs, health homes, and other changes in health care delivery and financing. These and other developments may offer new opportunities for MCOs to understand patterns of health care use and costs associated with chronic homelessness and PSH, and to become partners in financing services in PSH in more communities.