Typically, street medicine programs are financed through multiple funding streams, including grants and philanthropic investments. Street medicine programs also bill for services through federally qualified health centers, academic health systems, and other parent organizations.
In 2023, the Centers for Medicare & Medicaid Services created a place of service code that allows health care providers, including street medicine providers, to bill Medicaid and Medicare for services provided in a street-based setting. Street medicine programs working in states with Medicaid managed care programs need to contract with managed care organizations (MCOs) to receive Medicaid reimbursement for the services they provide. This contracting process includes rate negotiation, which is likely a new process for street medicine providers and one that requires preparation.
This tip sheet offers practical guidance to help street medicine programs engage in rate negotiation with MCOs, including around:
- Understanding a street medicine program’s budget and costs;
- Preparing for negotiations ahead of time;
- Considering the MCOs perspective; and
- Avoiding potential pitfalls.
The tip sheet is a product of Partnerships for Action: California Health Care & Homelessness Learning Collaborative, led by the Center for Health Care Strategies with support from the California Health Care Foundation.
