Payers Alert Communities About Medicaid Redetermination Renewal

Alliance of Community Health Plans (ACHP) shared how its community health plan members are preparing Medicaid enrollees for the Medicaid redetermination process in a fact sheet.

The redetermination process occurs on an annual basis when Medicaid assesses enrollees’ eligibility for the program. The process requires enrollees to disclose their income. If they do not share this information or if the number is above the threshold for eligibility (currently 138 percent of the federal poverty level), then their coverage ends.

When the coronavirus pandemic struck the US, redeterminations were put on hold in order to protect coverage for Medicaid beneficiaries. Moreover, during the pandemic, many Americans received Medicaid coverage.

As a result, many Americans stand to lose coverage when the public health emergency ends and redetermination resumes. Payers are using both community-wide and member-specific methods to spread awareness about Medicaid redetermination renewal. Community health plans may be particularly well-positioned for this effort due to their closeness to the populations they serve.

“ACHP member companies have worked hard to implement strategies to ensure a smooth Medicaid redetermination process that aims to preserve coverage for current Medicaid enrollees,” the fact sheet explained.

Capital District Physicians’ Health Plan (CDPHP) in upstate New York and SelectHealth will leverage public service announcements to share information about redetermination with the broader community.

In addition to these broader efforts, CDPHP and other payers—such as Kaiser Permanente—will pursue targeted methods of ensuring that members are aware of the process by sending communications to members who are approaching their renewal date and collaborating with the state to conduct outreach to more vulnerable and underserved member populations.

Kaiser Permanente will try to connect ineligible members with coverage through the marketplace.

Presbyterian Health Plan and the state of New Mexico are collaborating on a campaign to make members aware that they need to update their contact information with their Medicaid plans. The payer has also instituted various touchpoints where members can connect with the plan, such as call centers and outreach programs.

SelectHealth is using digital methods to reach members about their Medicaid eligibility. For example, the payer is using digital banner ads and social media to spread awareness about the end of the public health emergency.

SelectHealth will communicate to members that they need to update their contact information through flyers and social media. The plan will also use these channels of communication to tell members that they can change their language settings and to share timely developments with them.

UCare and the Minnesota Medicaid agency along with other managed care organizations in the state leveraged lessons from the coronavirus pandemic to identify communities in Minnesota that may experience systemic barriers to Medicaid entry, rampant care disparities, and a higher coverage churn rate.

AHIP has recommended using texts and pre-recorded calls to support Medicaid enrollment processes. Other experts have supported revamping ex parte renewals—a process by which enrollees are re-enrolled without having to submit paperwork.

The Massachusetts Medicaid program could use community-level outreach, ex-parte renewals, partnerships between the state and managed care and accountable care organizations, renewed communications strategies, and hiring more caseworkers to ensure that fewer Massachusetts residents are left without coverage, experts have recommended.

Experts are anticipating that 15 million beneficiaries could lose Medicaid coverage when the public health emergency ends.