Leveraging the Power of Digital Communications in Partnership with Human Connection to Drive Medicaid Re-Enrollment

In recent weeks it has been reported that the COVID-19 relief laws Congress enacted in 2020, which prohibit states from removing people from Medicaid, will end next month, meaning that local governments can resume eliminating people who no longer qualify or do not furnish the required personal information, including address, income, and household size.

This process, known as Medicaid redetermination, removes people who can no longer prove their eligibility in the correct form and timeframe from Medicaid entirely. The Kaiser Family Foundation estimates that between five and 14 million people could lose their Medicaid coverage once the continuous enrollment provision ends.

Despite the far-reaching and potentially devastating consequences of this Medicaid eligibility change, approximately?64% of Medicaid members have heard nothing at all about upcoming enrollment requirements. From both a population health and health equity perspective, this is discouraging news. People without insurance are less likely to seek care, which can lead to late diagnoses, high ED usage, and other adverse consequences that not only result in poor health outcomes but higher overall healthcare costs. As an industry, it is our duty to provide access to preventative care, chronic care and acute treatment when and where needed, but by neglecting to inform and engage these populations to re-enroll in their Medicaid plans, we are failing to practice what we preach.

Patients aren’t the only ones who will be affected by upcoming Medicaid redetermination requirements. Health systems and medical groups facing slim to negative operating margins risk further adverse financial impact with declining enrollees. Many expect to increase staffing for point of care enrollment, adding to cost and inefficiency. Medicaid managed care plans expect to see significant month over month variability in enrollment rates and up to 20-35% of revenue at risk.

There are both clinical and financial incentives for all involved to keep patients enrolled – it promotes quality through preventive care and protects reimbursement when a patient seeks care, not to mention it’s both less risky and more efficient to prevent them from losing coverage in the first place than it is to attempt to re-enroll them again in the future. Connecting with the Medicaid population to make them aware of these changes and encourage them to validate their qualification can also be a daunting task, especially after years of potentially lapsed contact.?

States should re-examine how they engage with their Medicaid populations, including taking a closer look at individuals’ specific needs and preferences. And a one-size-fits-all approach to communicating with this audience will likely prove unsuccessful at the necessary scale. We cannot overlook the need for multi-lingual, culturally sensitive content unique to each person’s motivations. Educating each patient in advance of their redetermination date and activating those still at risk when the deadline looms through an omni-channel approach could tremendously improve effectiveness, ensuring that people don’t get lost. ?We have seen firsthand how leveraging digital communications in partnership with human efforts maximize patient engagement results and at scale – and this is a critical moment to embrace that approach.