The federal government’s procedural steps to end the public health emergency related to the Covid-19 pandemic could lead to millions of Medicaid patients being uninsured and uninsured — including many who are still eligible for Medicaid.
For health systems, the so-called “removal” of Medicaid’s continued coverage underscores the need to engage these vulnerable populations to ensure they maintain Stable Insurance Coveragewhich is necessary to provide preventive care, protect the continued treatment of patients with chronic diseases and disabilities, and manage long-term outcomes and costs of care.
“unwind,” which refers to the process by which states resume annual Medicaid eligibility reviews after the public health emergency, which could begin as early as Aug. 1, so it’s important that providers have plans now to help patients who may be affected.
Millions at risk when eligibility redetermination resumes
When the federal government officially declared the pandemic a “public health emergency,” Congress provided additional Medicaid payments to states during the emergency, provided the states maintained a “continued” for those on Medicaid when the emergency began cover”.States stop enforcing Medicaid re-eligibility due to continuation coverage clause, which prevent A large number of patients lost their insurance during the pandemic.
Medicaid re-eligibility is the requirement that states must verify a patient’s eligibility for Medicaid at least annually. More than 10% of Medicaid enrollees gain or lose coverage during the year due to periodic redetermination and mid-cycle changes in eligibility. According to the Commonwealth Fund, part of this churn is the result of “procedural reasons” such as a lack of required paperwork because beneficiaries have moved or difficulty obtaining proof of income. Medicaid patients who lose coverage may eventually regain coverage, but often have to live with gaps in care.
States will be responsible for reinstatement of eligibility once the public health emergency is over. The federal government has committed to notifying states at least 60 days before the public health emergency expires (as of this writing, the PHE is scheduled to end in mid-July, but is expected to be extended until mid-October). Nearly all of the 84 million people enrolled in Medicaid will need to re-eligibility after the emergency ends — a huge challenge for states that could lead to procedural issues that could result in Medicaid-eligible patients losing coverage.
Three Steps to Improving Patient Engagement
To help prevent vulnerable patients from losing the coverage they need and deserve, health systems can take three steps to increase patient engagement:
1. Informing Medicaid patients that they need to re-enroll: When attempting to re-determine eligibility, Medicaid agencies will first attempt to perform automatic updates based on information available to them, such as salary information from state databases. If it fails, states will send updated notices and eligibility forms to patients, who must respond in a timely manner. Medicaid eligibility will expire for patients who have been re-identified who have been denied or cannot be reached by states.
Providers must work with patients to educate them about the redefinition process. For example, some enrollees may have moved during the pandemic, and if the state does not have their current contact information, they will not be notified of an update due. Additionally, renewal forms are often confusing, and the action steps for enrollees can be unclear. Additionally, not all states allow enrollees to complete updates online or by phone, according to the federal fund. Providers can work with their patients to ease these burdens, reminding patients of critical paperwork and providing resources to support them through the process.
2. Take this opportunity to strengthen the doctor-patient relationship: Health systems can use patient education needs redefined around Medicaid eligibility as an outreach opportunity to strengthen or re-establish relationships with patients, such as providing them with the ability to participate in care management programs.
Patient navigators can play an important role in strengthening the relationship by helping them successfully update their coverage. Navigators can help in a number of ways, including: Helping enrollees update their state’s Medicaid agency contact information before the emergency is over; Notifying enrollees who must renew in 2022 Watch out for mail from Medicaid agencies and promptly Respond to any requests; and help people who are no longer eligible for Medicaid apply for other health coverage. These team members can also help patients schedule appointments with primary care providers and specialists, ensuring coverage and continuity of care.
3. Make sure outreach is omnichannel and multilingual: A key component of patient engagement involves communicating with patients on their terms using their preferred communication method. Omnichannel outreach can be performed via email, traditional mail, phone calls, and text messages—or any combination of these. In addition, providers should provide communication materials in multiple languages based on the needs of the patient population. Monitoring the results of outreach activities can inform health system initiatives by highlighting effective activities that can be scaled up and identifying unengaged populations who may need more creative engagement efforts.
While no one is sure when the officially designated public health emergency will end, it is almost certain that it will come soon, and then the “relaxation” will begin. Until then, providers should examine ways to increase patient engagement, such as informing Medicaid patients that they need to re-enroll, re-establish strong patient-provider relationships, and conduct omnichannel, multilingual outreach.
