Medicaid Redetermination: Supporting Medicaid Administrators and Recipients in an Evolving Healthcare Landscape

The pending expiration of the public health emergency (PHE)—and the Medicaid redetermination process that will follow upon its expiration—is a looming concern for Medicaid administrators across the nation. In place since January 2020, the PHE has granted numerous flexibilities and waivers to healthcare systems and agencies, including allowing continuous Medicaid enrollment. When the PHE eventually expires, the majority of the country’s nearly 90 million Medicaid and CHIP recipients will be required to complete the redetermination process to ensure their continued eligibility.

While the official end date of the PHE is still unknown as of the writing of this article in mid-August (the last announced end date is October 13, but the Department of Health and Human Services has promised to give at least 60 days’ warning before the official end date, which has not yet happened), Medicaid agencies need to start preparing for the work to come when redeterminations start. In speaking with MTM, Inc. 's partners at state Medicaid programs, the primary concern is the transient nature of many Medicaid recipients. This is a population that tends to move frequently—which means administrators may not have recipients’ latest addresses or phone numbers when the need for redetermination hits. Ultimately, millions of Medicaid recipients could be in danger of losing their coverage because administrators don’t have their correct mailing addresses on file to initiate the eligibility redetermination process.

Many states are trying to get ahead of this issue by encouraging recipients to update their contact information online. As a partner in providing non-emergency medical transportation (NEMT) to more than 13 million Medicaid recipients nationwide, MTM is in a unique position to help our clients with this initiative—particularly among NEMT utilizers. We’ve committed to helping our clients with education around the redetermination process, as we are frequently in contact with recipients when they schedule rides to their medical appointments. We are using this unique line of communication to support redetermination efforts, specifically by educating recipients that they may need to start their eligibility reviews soon and directing them to update their contact information with their Medicaid agency.

Here are some of the ways we’re supporting these efforts as the PHE expiration looms:

• Adding banners and links on our state-specific web pages, like Nevada. NEMT utilizers frequently visit these pages for transportation information. We’re adding banners to these pages warning recipients of upcoming eligibility reviews and linking them to the appropriate state pages to update their contact information.
• For recipients who interact with us via phone vs. online, we can also add messaging to our IVA. When recipients call in to schedule their rides, they hear a message while waiting to speak to a representative. This message could inform them that they may need to have their Medicaid eligibility reviewed soon and encourage them to visit the appropriate website or call their state’s Medicaid agency to update their contact information.
• Similarly, we’re also able to add scripting to the end of each phone call that prompts our Representatives to ask recipients if they’ve had a change to their mailing address. We’re exploring the possibility of warm transferring callers with changes directly to their state’s agency, or instead collecting that updated information and reporting it back to the client on a regular basis.
• For our clients who are willing to add redetermination appointments as approved NEMT trips, we are also able to schedule rides for recipients to get to their eligibility appointments, making these appointments more accessible to the transportation disadvantaged community.
• We are also exploring the possibility of other creative ways to assist, such as have our transportation provider partners distribute educational flyers to recipients during their rides to appointments, as well as initiating outbound calls, text messages, or emails to NEMT utilizers.

MTM has always been a collaborative partner for our Medicaid clients as they face new challenges. This challenge is no different. We are committed to helping our clients navigate the evolving Medicaid landscape, as well as ensuring that vulnerable Medicaid recipients understand their eligibility is at risk of expiration—ultimately protecting their access to healthcare and helping us achieve our vision of communities without barriers.?