When the public health emergency ends, between 12-14 million people could lose Medicaid coverage, according to various estimates. Adults with and without children will be the hardest hit (see figure below). Healthcare organizations should be very concerned about the impact this loss of coverage will have on already thin margins and uncompensated care costs. It is particularly concerning if you are located in a state that didn’t expand Medicaid, and if you are a rural hospital or community-based organization.
Issues Medicaid Agencies Will Face
State agencies are gearing up for the end of the Medicaid continuous coverage provision, which they anticipate will occur in July. But with 78.9 million people—nearly 1 in 4 Americans—enrolled in Medicaid as of December 2021 (CMS), they will be severely challenged.
State Medicaid agencies face three major hurdles:
- Outdated enrollee contact information
- Lack of response to renewal requests
Staffing is an issue throughout the US, impacting nearly every industry. States will have difficulty attracting adequate staff to process large volumes of assessments.
Learn how American Exchange partners with healthcare organizations to overcome staffing issues:
- How to Solve Your Revenue Cycle Staffing Shortage
- How to Fix Your Revenue Cycle Management Department
Outdated enrollee contact information will make it difficult to reach enrollees. Some people enrolled when the pandemic first began two years ago. Many people have moved since they enrolled, especially since the Federal Eviction Moratorium ended.
Lack of response to renewal requests further exacerbates the problem. Many enrollees who receive their notices don’t understand what they need to do to stay enrolled. Others simply overlook the notice and don’t respond. Since states are not required to follow up with enrollees who don’t respond, these enrollees will be disenrolled.
Solidify Your Intake and Enrollment Process Now to Lessen Your Risk
Many people who will lose Medicaid coverage when the PHE ends will be eligible to enroll in Affordable Care Act (ACA) marketplace plans. Some may be eligible for subsidy programs or Medicare. You need a plan in place now to minimize your risk from serving uninsured patients, especially ones who are eligible for free or low cost marketplace plans.
Creating an integrated insurance assessment and enrollment process is the best way for your healthcare organization to maintain a healthy margin and reduce your uncompensated care costs. If you don’t have the staff to handle insurance assessments or are tired of patients slipping through the cracks when you refer them to an enrollment vendor, call American Exchange.
Healthcare Enrollment Experts
American Exchange’s insurance benefits management experts can efficiently assess and enroll your eligible patients in ACA, Medicare, and Medicaid health plans that fit their needs. Our seamless process prevents patients from falling through the cracks. We also provide year-round call center support to help patients navigate the healthcare system, and access in-network services for their healthcare needs. This creates a steady stream of revenue for your organization.
Read Addressing Uncompensated Care through Enrollment Services to learn how American Exchange can improve your margins and boost your revenue. Or contact us today to schedule a call.