Medicaid MCOs Try Multiple Touchpoints to Boost Redetermination Awareness

Effective April 1, states were allowed to begin disenrolling people from Medicaid who no longer qualify after a multiyear pause during the COVID-19 public health emergency (PHE). Yet data from the federal government suggests many people are losing coverage for procedural reasons, and surveys show a concerning lack of awareness regarding the redetermination process. Medicaid managed care organizations say they are working to supplement outreach efforts from state and federal agencies and are trying a variety of tactics to activate impacted members, including text messaging and notifications at the pharmacy. Since the start of redeterminations, CMS has clarified that states may rely on MCOs to assist enrollees with completing and submitting renewal forms and even pay them for this type of work.

KFF estimates that at least 4.77 million Medicaid beneficiaries have been disenrolled as of Aug. 15, with three quarters of disenrollments occurring for procedural reasons. HHS had previously estimated that 8.2 million people will no longer qualify for Medicaid once redeterminations resumed and find other coverage, while 6.8 million Medicaid enrollees could lose coverage despite still being eligible.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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