Eligibility and Redetermination: What’s Happening Now in Medicaid

Redetermination cycles and new work requirements are creating immediate operational and coverage challenges for Medicaid-dependent organizations. This isn’t a future risk; it’s happening now, and health systems, payers, and safety-net providers are managing the impact today.

This session brings together Arcadia Chief Medical Officer Dr. Luke Hansen and Sarah Schauman, VP of Operations at Integrated Health Partners (IHP), an FQHC-controlled network serving a predominantly Medi-Cal population in Southern California, to discuss how an FQHC network is handling eligibility churn and redetermination on the ground, and what it takes to keep patients covered and care uninterrupted.

The conversation widens from there to the broader financing picture under H.R. 1, including the growing role of provider and managed care taxes in state Medicaid funding, and what happens to hospital financing as more patients lose coverage. A grounded look at current impact, not a forecast.
 

What You'll Learn

1. How redetermination and new work requirements are affecting Medicaid enrollment and continuity of coverage right now, and the administrative and patient-care burden this is creating for FQHCs and other safety-net providers.
    
2. What an FQHC-controlled network is doing operationally to keep eligible patients enrolled through redetermination, drawn from Integrated Health Partners’ experience serving a predominantly Medi-Cal population.
    
3. How these immediate eligibility pressures connect to the broader Medicaid financing picture under H.R. 1, including changes to provider and managed care tax mechanisms and what they mean for state funding and provider reimbursement.
    
4. How states are responding to funding pressure on hospitals facing a larger uninsured population as coverage losses mount, and what support mechanisms are emerging (or falling short). 
   
    

Speakers: