How to help your Medicaid beneficiaries re-enroll and retain coverage
Over the past three years we’ve been under a public health emergency (PHE) caused by Covid-19, which required states to provide continuous coverage to Medicaid members. Now, beneficiaries have to resubmit their income statements and other information to keep their coverage, putting 15 million people, including 6 million children, at risk of losing healthcare benefits.
“The past few years due to the public health emergency, folks did not need to re-enroll, so now we're fearing that there's going to be quite a bit of chaos when this unwinding starts,” said Jessi Cardello, Director of Account Operations at Arcadia. “This redetermination means that folks are going to need to reapply, but a lot of folks are uncertain if they're impacted or not.”
Cardello joined Arcadia Director of Enterprise Partnerships Josh Cabana and Senior Manager Nina Zelcer to discuss the coming "redetermination crisis" and what ACOs, CINs, health systems and hospitals, and payer organizations can do to help their members and patients navigate the complex paperwork required to retain coverage in the webinar, Unwinding the PHE.
Narrowing the coverage gap with early outreach strategies
Healthcare organizations fear there will be a gap in coverage either because patients are either unaware that they'll be impacted and show up for their visit without the coverage they need or assume their coverage changed and they stop seeing their physician and picking up pharmaceuticals.
“I like to think about the things that are at risk ... it's good preventive care, it's chronic disease management, it's access to emergency services,” explained Cabana.
Cabana says two main things can help health systems limit the risk to population health: being proactive in their outreach and breaking the problem down into manageable pieces and applying technology to help handle those pieces.
Zelcer agrees, “Part of that would be arming office staff and providers with frequently asked questions, documentation, or questions to get this information out to your providers as best as possible.”
She says to start the process now and points out that it’s ok to let providers know that the information will be continuously updated as more is learned.
“That way, at least you can start the preparations and know what to look for, for new dates or new timelines, and how to disseminate that information as it comes up and becomes readily applicable to our beneficiaries,” she added.
Proactive outreach relieves anxiety for beneficiaries and helps with operational efficiency.
“We all work in healthcare and have questions about how this is going to work, it's going to be even more magnified for folks who don't live and breathe this every day, so getting out ahead of it can help with some of the anxiety on the beneficiary side and prime them for good engagement with this system,” said Cabana.