End of Continuous Medicaid Coverage Presents Opportunity to Boost Patient Engagement

A procedural decision by the federal government to end the public health emergency associated with the Covid-19 pandemic could lead to the loss of their coverage and the uninsurance of millions of Medicaid patients, many of whom are still eligible for Medicaid.

For health systems, the so-called “denouement” of continued Medicaid coverage underscores the urgent need to engage this vulnerable population to ensure they maintain stable insurance coverage, which is necessary to provide preventive care, protect the ongoing treatment of people with chronic disease. disease and disability, and managing long-term outcomes and the cost of care.

“Denouement,” which refers to the process by which states resume annual Medicaid eligibility reviews after the public health emergency ends, could begin as early as August 1, so it’s important for providers to develop plans now to help patients who may be affected.

Millions at risk when eligibility reviews resume

When the federal government officially declared the pandemic a “public health emergency,” Congress extended additional federal Medicaid payments to states during the emergency, on the condition that states maintain “continuous coverage” for those enrolled in Medicaid when the emergency started. Due to continued coverage, states stopped conducting Medicaid eligibility reassessments, which prevented large volumes of patients from losing coverage during the pandemic.

The new Medicaid eligibility determinations refer to a requirement that states must check patients for Medicaid eligibility at least once a year. More than 10% of Medicaid enrollees gain or lose coverage during the year due to periodic reviews and mid-cycle eligibility changes. Some of this turnover is the result of “procedural reasons” such as a lack of required documents because beneficiaries have moved or have difficulty obtaining proof of income, according to the Commonwealth Fund. Medicaid patients who lose coverage can eventually get it back, but often have to experience gaps in care.

Once the public health emergency expires, states will be responsible for resuming new eligibility determinations. The federal government has committed to giving states at least 60 days notice before the public health emergency expires (at the time of this writing, the PHE is scheduled to end in mid-July but should be extended until mid-October). After the emergency ends, nearly all of the 84 million people enrolled in Medicaid will need to review their eligibility — a daunting challenge for states that could lead to procedural issues causing Medicaid-eligible patients to lose coverage. .

Three steps to better patient engagement

To help prevent vulnerable patients from losing the coverage they need and deserve, healthcare systems can take the following three steps to improve patient engagement:

1. Inform Medicaid patients of the need to re-enroll: When attempting to re-determine eligibility, Medicaid agencies first attempt to auto-renew based on information available to them, such as salary information from state databases . If that fails, states will then send renewal notices and eligibility forms to patients, who must respond in a timely manner. For patients whose redeterminations are denied or states are unable to contact, Medicaid eligibility will expire.

Providers should work with their patients to educate them about the review process. For example, some registrants may have moved during the pandemic and will not be notified that their renewal is due if the state does not have their current contact information. Additionally, renewal forms are often confusing and action steps for registrants may not be clear. Additionally, not all states allow registrants to renew online or over the phone, according to the Commonwealth Fund. Providers can partner with their patients to ease these burdens, reminding them to keep an eye on critical documents and offering resources to support them through the process.

2. Use the opportunity to strengthen the patient-provider relationship: Health systems can use the need for patient education regarding new Medicaid eligibility determinations as an outreach opportunity to strengthen or restore relationships with patients, offering them the opportunity to enroll in programs care management, for example.

Navigators can play an important role in strengthening relationships by helping them successfully renew their coverage. Navigators can help in many ways, including: helping enrollees update their contact information with their state’s Medicaid agency before the emergency ends; advise enrollees who are due to renew their coverage in 2022 to be on the lookout for mail from the Medicaid agency and respond to any inquiries in a timely manner; and helping people who are no longer eligible for Medicaid apply for other health insurance coverage. These team members can also help patients schedule appointments with primary care providers and specialists, ensuring continuity of coverage and care.

3. Make sure awareness campaigns are omnichannel and multilingual: A key part of patient engagement is communicating to patients on their terms with their preferred communication methods. Omnichannel outreach campaigns can be done through email, traditional mail, phone calls, and text messages — or any combination of these. Additionally, providers should offer communication materials in multiple languages, depending on the needs of their patient populations. Tracking the results of awareness campaigns can inform health system initiatives by highlighting effective campaigns that can be scaled up and identifying disengaged populations where more creative engagement efforts may be needed.

While no one knows exactly when the officially designated public health emergency will end, it will almost certainly arrive soon, and then the “denouement” will begin. Before that, providers should consider ways to build patient engagement, such as informing Medicaid patients of their need to re-enroll, rebuilding strong patient-provider relationships, and conducting omnichannel and multilingual outreach.

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