Persons experiencing housing instability (PEHIs) face significant health risks and often have poor health outcomes, high use of clinical services, and increased mortality. A study conducted through focus groups at two homeless shelters in Kentucky examined how Medicaid managed care organizations (MCOs) and community-based organizations (CBOs) work together to address the needs of homeless Medicaid enrollees.

Qualitative analysis revealed three main themes: the benefits and barriers to accessing services through Medicaid, the poor integration of Medicaid with community shelters, and a lack of information available to Medicaid enrollees living without housing. Participants expressed concerns regarding obstacles to receiving services, the need for improved resource and referral processes, and enhanced communication between CBOs and Medicaid enrollees.

The findings indicate that PEHIs depend on shelters for support in enrolling in and using Medicaid, rather than Medicaid proactively connecting them with CBOs. There are clear opportunities for MCOs to enhance their interactions with PEHI enrollees, who navigate these systems differently than other Medicaid recipients. Addressing these issues is crucial for improving care and health outcomes for this vulnerable population.