Medicaid Unwinding Update: People are Falling Off the Cliff

What You Need to Know

Based on data from Kaiser Family Foundation's regularly-updated Medicaid Enrollment and Unwinding Tracker, it does appear that large numbers of eligible people are getting disenrolled from the Medicaid program.  

• Based on reporting from 45 states and the District of Columbia, 37% of people who have gone through the renewal process have been disenrolled. KFF notes that due to how states report their data, this undercounts the actual number of disenrollments to some degree.
• There are huge variations in disenrollment percentages by state. For example, as of early August, Texas had disenrolled 72% of the individuals for whom it has conducted renewals, while in Wyoming that number was only 8%. (CMS has intervened in more than a dozen states with inordinately high disenrollment rates to halt the revalidation process. As a result of CMS's involvement, Texas, for example, will be reinstating 90,000 of the roughly 600,000 individuals disenrolled from that state's Medicaid program. Several other states have voluntarily paused re-enrollment to troubleshoot the high disenrollment rates.)
• Nearly 75% of people disenrolled have had their coverage terminated for procedural reasons. These are cases where disenrollment results from the enrollee not completing the renewal process. This can happen because the enrollee has moved and the state is sending re-enrollment information to an outdated address or because the enrollee doesn’t understand or complete information requests with specified time frames. (Several states have been criticized for sending written materials that are confusing and unclear.) Many of these people are likely eligible for Medicaid based on the needs-based criteria that apply. 

What This Means For You

If you provide care to Medicaid enrollees, it is important to understand that the revalidation process is ongoing. If you have started outreach to this group of patients, continue. But if you haven't, it isn't too late to still protect those individuals from getting improperly disenrolled. As we noted in our March 1st R&R post, the first step is to type the following terms into your search engine of choice: "[your state] Medicaid unwinding." This will help you quickly locate materials applicable to your state's Medicaid revalidation process.

 Next, raise awareness with your Medicaid patients about the importance of immediately updating their contact information with Medicaid. Reach out to them via company newsletters, email, social media, and by posting information about Medicaid revalidation prominently in your office by the check-in area. The best way to avoid getting disenrolled for technical reasons is to first receive the communications from Medicaid. The majority of states now permit enrollees to update their information online. Learn how your state permits enrollees to update their contact info and pass that on to your patients. 

 Third, consider encouraging patients to update their contact info while at your facility. While this could create an increased burden on your patient-facing front-office staff, it will help ensure that these individuals can receive medically necessary continuous coverage from you. And encourage patients confused by mailings they do receive to bring them to your office so your reimbursement experts on staff can help them understand exactly what's being asked of them and what the deadlines are for responding. 

 This revalidation process has a direct impact on your Medicaid patients' ability to receive care from you. It is in (a) your patients' best interests from a health perspective and (b) your organization's interest to ensure that people enrolled and eligible for Medicaid remain in that program without interruption. Revalidation will continue through this year into next. We encourage you to aggressively stay on top of this issue moving forward to ensure that your Medicaid patients can continue to receive care from you.