A Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants in Permanent Supportive Housing. 8.4. Changes at the Provider Level


For their clients and patients to benefit from these evolving innovations, health care providers and the provider organizations that work with people experiencing chronic homelessness or living in PSH will have to make parallel changes. Those that are not already Medicaid providers will have to become qualified themselves, or partner with agencies that are already Medicaid providers, to deliver and bill for covered services. Several aspects of their current operations may need significant investment to build infrastructure and organizational capacity, including staffing, administrative systems, and ability to produce electronic health records and exchange them securely with other providers serving their clients.

Service providers must make substantial investments in staff credentialing, training, and development; leadership development; and management to make the shift to Medicaid reimbursement if programs have relied on grant funding, fee-for-service, or other forms of Medicaid payment. They will have to implement electronic health records and data management systems that can serve their own purposes and also interact with systems operating at other providers and with Medicaid systems. They will also have to prepare administratively to participate in new Medicaid financing arrangements while simultaneously sustaining programs that rely on existing payment mechanisms. Finally, many will find that they can better serve their clients if they establish partnerships or implement new practice models to deliver more effective and integrated care. Some states and health care providers have received substantial support from foundations to supplement public investments by state and local governments and federal grants to make the investments needed to prepare for the future.

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