{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:37:14Z","timestamp":1790775434450,"version":"4.1.0"},"reference-count":54,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec id=\"ab-ysc250009-1\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>\n                      People experiencing unsheltered homelessness face high rates of psychiatric illness and substantial barriers to care. Field-based psychiatric services built on direct outreach (known as\n                      <jats:italic toggle=\"yes\">street psychiatry<\/jats:italic>\n                      ) may improve care and facilitate housing while possibly reducing total health care spending, but inadequate funding limits implementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ysc250009-2\">\n                    <jats:title>Observations<\/jats:title>\n                    <jats:p>Literature shows that street psychiatric services are currently financially supported by a variety of sources, though with outsized reliance on public and private grants and contracts. Health plan reimbursement for this care remains limited. Existing payment innovations that support street medicine and other care models illustrate the spectrum of possible reimbursement mechanisms available to payers. Payers could ensure that services are reimbursed by facilitating use of the new outreach site\/street place of service code, compensating necessary activities of outreach and reimbursing activities of peer specialists and other interdisciplinary team members. To pay for services outside the scope of billable encounters, payers could develop programs to directly fund or incentivize care coordination, housing support, and other services. Sufficient fee-for-service rates and risk adjustment may encourage and support care for this population. Maintaining or expanding Medicaid eligibility and limiting administrative barriers to coverage for people experiencing homelessness are essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ysc250009-3\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The need for outreach-informed psychiatric care continues to grow. Payment model reforms may enable practitioners to deliver evidence-based street psychiatry at scale. Successful programs and states demonstrate that the described reforms are likely feasible and effective. Patients experiencing unsheltered homelessness, some of whom have substantial psychiatric care needs, are likely to benefit greatly from improved reimbursement for these services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2025.4460","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:30:41Z","timestamp":1770827441000},"page":"529","source":"Crossref","is-referenced-by-count":1,"title":["Sustainably Funding Street Psychiatry"],"prefix":"10.1001","volume":"83","author":[{"given":"Benjamin Land","family":"Gorman","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Koh","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Psychiatry, Massachusetts General Hospital, Boston"},{"name":"Boston Health Care for the Homeless Program, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Roe","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"},{"name":"Population Health Services, Boston Medical Center Health System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"ysc250009r1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1377\/hlthaff.2019.00687","article-title":"Health care spending and use among people experiencing unstable housing in the era of accountable care organizations.","volume":"39","author":"Koh","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"ysc250009r2","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1176\/appi.ps.201200515","article-title":"Criminal behavior 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