State strategies for establishing connections to health care for justice-involved populations: The central role of Medicaid

Issue: With many states expanding Medicaid eligibility, individuals leaving jail or prison are now often able to enroll in health coverage upon release. It is increasingly clear, however, that coverage alone is insufficient to address the often complex health and social needs of people who cycle between costly hospital and jail stays.

Goals: To identify emerging trends in the care delivery models that state Medicaid programs use for former inmates.

Methods: Literature review and interviews with state officials, plans, and providers.

Key Findings: The care delivery models for individuals leaving jail or prison provide comprehensive primary care, typically including: data exchange to ensure providers are notified when someone is leaving jail or prison; "in-reach" to help inmates establish a relationship with a primary care provider prior to release, identify health conditions, and set up community-based care; strategies for addressing housing issues and other social determinants of health; use of a peer-support specialist who has experienced incarceration; and specialized training for primary care providers and specialists who work with the formerly incarcerated.

Conclusion: With a foundation of insurance coverage, states have developed a range of promising, replicable approaches to providing care to people leaving jail or prison.