Community-Based Orgs Can Help Manage Post-PHE Medicaid Coverage Changes

Through collaborating with community-based organizations, family-led organizations, and individuals with lived experiences, states can help guide their communities through Medicaid coverage changes that may occur when the COVID-19 public health emergency (PHE) ends, according to an issue brief from Manatt Health.

States have maintained continuous enrollment for Medicaid beneficiaries and paused Medicaid and Children’s Health Insurance Program (CHIP) renewals and disenrollments for the duration of the PHE. However, states must begin redetermining Medicaid eligibility once the PHE is over, which may result in coverage losses for millions of children and families.

Many families may not receive important documents from Medicaid and CHIP agencies that detail how they can continue their Medicaid coverage or transition to marketplace coverage. Incorrect mailing addresses on file or delays in response times could prevent eligible children from maintaining health insurance coverage.

Manatt Health partnered with the Lucile Packard Foundation for Children’s Health to recommend ways that states can work with community-based organizations to mitigate the number of children and families who lose coverage when the PHE ends.

States should prioritize community engagement initiatives that include individuals with experience navigating Medicaid and CHIP who can connect with and relate to fellow community members.

When partnering with community-based organizations, family-led organizations, and experienced individuals, states must be sure to compensate them for their work, the brief noted. States could use American Rescue Plan Act (ARPA) funding, other state funds, or Medicaid and CHIP administrative funds to compensate their collaborators.

Working with Medicaid beneficiaries with lived experience can provide an opportunity for these individuals to provide ongoing feedback during the unwinding of the continuous coverage policy. States can leverage existing Medical Care Advisory Committees or similar organizations to engage these beneficiaries.

Alternatively, states could create an advisory group of people with lived experience to offer feedback on specific unwinding efforts. The advisory group could also be used to support other relevant community engagement following the PHE unwinding.

Partnering with community-based and family-led organizations can also help facilitate real-time communication and feedback between the community and the state. These organizations can develop task forces open to the community that meet regularly to discuss how the PHE’s ending will impact children and families. The organizations could then inform the state of any helpful feedback they received.

For example, a coalition in Missouri formed the Renewals and Ending the PHE Taskforce, comprised of providers, community-based organizations, and other advocates. The task force developed goals and questions for the state and planned to meet with Missouri Medicaid to help guide the unwinding efforts.

Community-based and family-led organizations are useful resources to provide direct support to Medicaid beneficiaries, such as helping to complete recertification forms. States could provide funding to establish telephone helplines through these organizations for community members to seek help with coverage questions.

Massachusetts supported a community-based outreach and education campaign that focuses on three areas. The campaign leveraged established community and faith-based groups to conduct outreach to individuals where they live and work. In addition, leaders canvassed communities with the highest potential for coverage loss to conduct one-on-one outreach and launched a local media campaign to reach diverse communities.

States should ensure that they communicate effectively with their racially, ethnically, linguistically, and culturally diverse populations, the brief said.

Managed care organizations (MCOs) can also coordinate with community-based organizations to improve member outreach efforts. States like Utah, Massachusetts, and Colorado depend on MCOs to update member contact information and relay upcoming policy changes. By partnering with community-based organizations, MCOs may be able to reach more beneficiaries and improve member engagement.

“States may choose to leverage any or all of the approaches described above, as they could complement each other and become increasingly impactful together,” the brief concluded. “The efficacy of the PHE unwinding will depend in part on enrollee engagement, which CBOs and family-led organizations are uniquely positioned to support.”