Medicaid enrollment has grown significantly for the reason that onset of the COVID-19 pandemic. As of Might 2021, whole Medicaid and CHIP enrollment was at 82.8 million, up by 11.5 million since February 2020. This security web has been important to the well being and well-being of tens of millions of individuals, equivalent to those that skilled job loss, and lack of employer-provided insurance coverage protection, because of the financial results of the COVID-19 pandemic.
As a situation of expanded federal funding, states needed to comply with “Upkeep of Eligibility” (MOE) necessities to make sure the continual protection of sure Medicaid enrollees throughout the pandemic. These MOE necessities are energetic all through the general public well being emergency, which has most not too long ago been prolonged via mid-January 2022. Which means that most state Medicaid redetermination processes have been on maintain since March 2020, creating an unlimited backlog of renewals.
Medicaid plans typically battle with maintaining their members’ addresses updated. By way of Cotiviti’s Eliza member engagement resolution, we all know that 60% of enrollees constantly report not receiving their renewal notices within the mail. This might be as a result of issues get misplaced in transit, within the shuffle of a busy family, or perhaps they’ve moved since making use of for advantages. Transience has doubtless elevated for the reason that onset of the pandemic with people and households shifting resulting from job losses, college closures, and housing instability.
As states compensate for renewals in 2022 and the general public well being emergency finally expires, plans ought to anticipate extra Medicaid disenrollment and churn. Researchers on the City Institute predict that Medicaid enrollment will decline by 15 million individuals as soon as the continual protection requirement of the Households First Coronavirus Response Act now not applies. This contains almost 9 million adults and almost 6 million youngsters. Some states have plans to proactively replace addresses previous to the top of the general public well being emergency, however the majority of state Medicaid plans don’t, in accordance with a survey performed by KFF and the Georgetown College Middle for Kids and Households.
Well being plans, notably these which can be in states that aren’t updating addresses, can put together for the reinstatement of redeterminations by gathering up to date member contact data and communication preferences now. This may enable plans to inform members when it’s time to renew advantages and keep away from pointless lack of protection.
Different actions Medicaid plans ought to think about embrace:
- Partnering with state Medicaid businesses to share up to date member contact data.
- Providing members a number of methods to replace their contact data together with via a member portal, customer support, and safe communications equivalent to interactive voice response and internet surveys.
- Utilizing each member interplay as a possibility to make healthcare extra accessible, equivalent to highlighting your member portal, telehealth advantages, or the way to entry a free COVID-19 vaccination.
Eliza multi-channel engagement facilitates customized interactions between well being plans and their prospects whereas gathering useful member-reported information that may’t be discovered on an enrollment file or declare. We’ve helped Medicaid plans enhance retention and income via administrative and medical expense financial savings by guaranteeing steady protection. Plans have gained greater than 9% enchancment in retention of these engaged.