When the pandemic started, Congress established the Families First Coronavirus Response Act (FFCRA) which included the requirement to keep people continuously enrolled in Medicaid programs through the end of the COVID-19 public health emergency (PHE) in exchange for enhanced federal funding.
This provision is coming to an end; on April 1, 2023, states will begin “unwinding Medicaid,” disenrolling beneficiaries who are no longer eligible, and returning to routine eligibility and enrollment procedures for Medicaid.
KFF estimates that between 5 million and 14 million people will lose Medicaid coverage once this provision ends.1
Many of these patients may still be eligible for Medicaid.2 However, they will be uninsured unless they re-enroll in Medicaid or transition to other health coverage. Those who become ineligible for Medicaid may qualify for other health coverage as well.
CMS describes this as “the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.”3
Update 8/28/23
CMS Takes Action to Protect Health Care Coverage for Children and Families
Is your facility ready?
Here are our suggestions for managing the forthcoming significant increase in your uninsured patient population:
1. Screen ALL uninsured patients at registration.
It is crucial to determine whether your patient qualifies for Medicaid, other third-party payer programs, and/or payment plans. Automated screening solutions allow any employee to walk through the screening process with the patient and get a real-time result at the end of the screening.
2. Run all uninsured patients through a Coverage Discovery solution.
Run all patients’ information through a Coverage Discovery solution to verify any existing and billable health coverage that may have gone unreported by the patient.
3. Assist patients with enrollment.
By assisting your patient with Medicaid (or other third-party payer) enrollment, you can help ensure the process is completed and the patient is covered for their next visit to your facility.
4. Educate patients about the unwinding of Medicaid.
Educate your patients about the risk of loss of coverage and the potential need to re-enroll in Medicaid. According to KFF, patients with limited English proficiency (LEP), patients with disabilities, and patients who have relocated since the start of the pandemic may be more at risk of losing Medicaid coverage.1 Remind patients to make sure their contact information is updated with CMS as soon as possible so that they receive any communications regarding their benefits or re-enrollment.
5. Follow up on applications.
Stay on top of those enrollments; missing documents may lead to denials. By following up regularly on applications, you can better ensure the patient is successfully enrolled in the program.
Unwinding Medicaid: EligibilityOne Is Here to Help
At EligibilityOne, we employ experienced Patient Advocates and state-of-the-art technology to provide you and your uninsured patients with the eligibility services listed above, and much more.
Our goal is to screen 90% of our clients’ uninsured patients before discharge and our Patient Advocates are available on site (including in the Emergency Department) to help patients at a minimum of 12 hours per day, 6 days per week in order to accomplish this objective and assist patients with applications and enrollments. Plus, our real-time dashboard reporting enables facilities to forecast their uninsured patient population and track enrollments.
By partnering with EligibilityOne and providing these services to your patients, you will help alleviate the return of Medicaid “churn.” This disenrollment and re-enrollment of Medicaid beneficiaries within short periods of time results in coverage gaps, administrative costs, and access barriers for patients who may not understand renewal procedures or forms.1 Our Patient Advocates can guide them through these processes to simplify and improve their patient experience.
As KFF states, “Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage.”1 Allow us to handle these efforts for you and make the unwinding of Medicaid as smooth as possible for your facility and patients.
Sources:
1 KFF – “10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision” (2023)
2 Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services – “Unwinding the Medicaid Continuous Enrollment Provision: Projected Enrollment Effects and Policy Approaches (Issue Brief HP-2022-20)” (2022)
3 Centers for Medicare & Medicaid Services – “Unwinding and Returning to Regular Operations after COVID-19” (2023)
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