Consumer / Employer, Payers

Few Managed Care Plans Have Current Contact Info for Medicaid Members as Redeterminations Loom

The continuous enrollment requirement, which barred states from disenrolling Medicaid members, will end March 31. About three-quarters of managed care plans anticipate 10% to 25% of their Medicaid enrollees losing coverage once the continuous enrollment provision ends.

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Just about one-third of managed care plans have verified or current contact information for between 76% and 100% of their Medicaid members, a recent survey found. 

The news comes as the Medicaid continuous enrollment provision is set to expire March 31 due to the Consolidated Appropriations Act. The requirement was part of the Families First Coronavirus Response Act and banned states from disenrolling people from Medicaid during the public health emergency (although the Consolidated Appropriations Act separated the requirement from the PHE, which will end in May). Starting April 1, states can resume disenrollments and Medicaid enrollees will have to undergo the redetermination process.

The Kaiser Family Foundation report, published Monday, was done in partnership with the Association for Community Affiliated Plans (ACAP). The organizations fielded a survey of Medicaid managed care plans that are members of ACAP between October and November. In total, 29 of the 65 plans responded to the survey, representing more than 13.2 million Medicaid beneficiaries in 15 states.

Most of the responding plans said they are reaching out to members directly to update their contact information and many are working with third parties, like providers and community-based organizations. Almost all of the health plans said that reaching Medicaid beneficiaries is difficult. 

“This information is essential to ensuring members receive renewal notices and other communication from the state and the plan,” the report stated.

About all of the responding plans said the state they operate in is planning to give monthly files on the members it is initiating the renewal process for, and more than half said they anticipate receiving monthly files on the members who have not submitted renewal information and could lose coverage. To help with Medicaid renewals, about one in five of the responding plans are hiring or planning to hire additional staff, the report found.

Additionally, about half of the plans said their renewal outreach strategy will have targeted efforts for certain populations, including for those with chronic conditions, pregnant members, postpartum members and those with mental illness or a substance use disorder.

“Plans indicated these targeted outreach strategies would include additional communication; customized messaging; call center and provider portal alerts for select members; leveraging care managers, transition teams, and life coaches; and partnering with [community-based organizations] to provide in-home application assistance for members with disabilities and homebound members,” KFF said.

About three-quarters of the plans anticipate 10% to 25% of their Medicaid enrollees losing coverage once the continuous enrollment provision ends. Another 83% of plans said they’re expecting a loss of revenue.

“During the unwinding, millions of people could lose coverage if they are no longer eligible or face administrative barriers to renewing coverage despite remaining eligible,” the report said. “The significant volume of work that states face will place a heavy burden on eligibility and enrollment staff and could contribute to disenrollments due to procedural reasons.

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