CommunityConnect Labs

5 Tips for Medicaid Unwinding

Out of 334 million people in the United States, 91 million are on Medicaid, with children being the largest eligibility group served.

In the next couple of months there will be an unprecedented volume of Medicaid renewals. Biden recently announced that the Public Health Emergency will end in May. All Medicaid enrollees who have been automatically redetermined for the last 3 years will need to renew using the normal process.

How do states solve this problem? Below are our top 5 tips for Medicaid Unwinding.

  1. Efficiently screen people for eligibility. Begin reaching out to your Medicaid population to create awareness and communicate important dates in the redetermination process.  Some members are new to Medicaid; others haven’t had to redetermine in years.  A significant portion will no longer be eligible due to various factors such as gains in income; allowing them to know their eligibility status through tools like eligibility screeners can effectively direct them to the appropriate resource, such as finding a plan on the marketplace.
  2. Hire competent Medicaid staff. You want people who are trained in dealing with low-income, homelessness, and underserved communities. It’s helpful to work with Medicaid Managed Care Organizations, health care providers and enrollment staff to ensure contact information is correct in the Medicaid system.
  3. Have a multichannel approach for contacting Medicaid recipients in multiple languages (i.e. email, contact center, screener & intake webform, virtual assistant and SMS services.)  Reach out early and often to make sure you have updated addresses, and that Medicaid members are aware of actions they have to take to preserve their coverage.
  4. Provide automated support such as multilingual chatbots on your websites.  This is critical to address member questions during weekends and before and after business hours, and to make sure there is an adequate response across different languages.
  5. Know the community and provide follow-up reminders to those who don’t take action by using SMS/Email/IVR calls.

    And a bonus tip:
  6. Monitor enrollment data to measure coverage losses and document any issues that occur by using follow-up surveys (sample questions “Were you able to keep your Medicaid coverage?” “Were you able to transition to other coverage?”)  You can take follow-up action such as offering a transition to marketplace plans and subsidies to those who drop from the Medicaid rolls.

Want to explore how a digital healthcare enrollment screening tool and contact center could save your staff time and energy? Talk with us.


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