As millions of Americans are expected to lose Medicaid coverage due to eligibility changes, it is crucial for Providers and health plans to work together to mitigate the impact on patients. The requirement for states to check eligibility for every American on Medicaid could lead to a significant number of individuals being disenrolled, potentially causing challenges in accessing necessary healthcare services.
According to the Kaiser Family Foundation, the number of individuals who could lose access to Medicaid is uncertain, but estimates range from 5.3 million to 14.2 million during the 12-month eligibility review period. Providers must be equipped to assist those who are disenrolled and ensure that patients continue to receive high-quality care.
Through partnership, collaboration, and commitment to equitable healthcare access, Providers and health plans can mitigate the risks of Medicaid eligibility changes and ensure that all patients receive the care they need.
How will Non-Qualified Individuals be Affected?
Non-qualified individuals who are no longer eligible for Medicaid coverage may face significant challenges accessing healthcare services, including routine check-ups, preventative care, and treatment for chronic conditions. Without Medicaid coverage, individuals may have to pay for healthcare services out of pocket or go without necessary medical care. This could lead to increased health complications and higher healthcare costs down the road.
In addition, individuals who lose Medicaid coverage may also face financial difficulties due to medical bills and expenses. They may have to rely on emergency rooms for medical care, which can be expensive and often result in higher out-of-pocket costs. Furthermore, they may face difficulties accessing prescription medications, which could lead to poor health outcomes.
The changes in Medicaid eligibility could have significant impacts on healthcare providers as well. Providers may see a decrease in the number of patients who have Medicaid coverage, which could lead to a decrease in revenue. This could be particularly challenging for providers who serve low-income communities where Medicaid coverage is more common.
Providers may also see an increase in the number of patients who are uninsured or underinsured, which can create financial challenges for both the provider and the patient. Patients who are uninsured or underinsured may be unable to pay for healthcare services, which can result in unpaid medical bills and decreased revenue for the provider.
Furthermore, providers may need to devote additional resources to helping patients navigate the healthcare system and find alternative sources of coverage. This can be time-consuming and may require additional staff or resources.
Best Communication Practices for Providers
One effective way of reaching a Medicaid recipient is through targeted outreach campaigns using multiple communication channels. This could include providers and managed care plans reaching out through:
- Direct mail: send targeted mailings to Medicaid recipients, providing information about their eligibility status and available healthcare services.
- Phone outreach: make phone calls to Medicaid recipients to provide personalized information and assistance with navigating the healthcare system.
- Text messaging: use text messaging to send reminders about upcoming appointments or to provide information about available healthcare services.
- Email: use email to communicate with Medicaid recipients about their eligibility status and available healthcare services.
- Social media: utilize social media to provide information about Medicaid eligibility changes and available healthcare services, and to engage with Medicaid recipients.
- Community Leaders: coordinate to identify and leverage community leaders and advocates to communicate with Medicaid recipients about the change in eligibility as well as various resources that are available to assist.
By utilizing multiple communication channels, Providers and Medicaid managed care plans can ensure that Medicaid recipients receive the information they need to access healthcare services and understand their eligibility status. This approach can help improve health outcomes and reduce the number of individuals who may lose coverage due to eligibility changes. Leveraging large providers who have recurring interactions with patients may help in those efforts. Patients expect communications from DME providers regarding their care and providers can serve as a single point of contact for collaborative efforts with health plans.
Next Steps Once Coverage is Terminated
Providers and health plans can take several steps to support patients once their Medicaid coverage is terminated, including:
- Helping patients understand their options: when seeking alternative healthcare coverage options can include employer-sponsored health insurance, coverage through the Health Insurance Marketplace, or free or low-cost clinics.
- Assisting with appeals: patients can file appeals with their state Medicaid agency if they believe their coverage was terminated in error.
- Providing affordable care options: offer affordable care options, such as sliding-scale fees or discounts for uninsured or underinsured patients.
- Connecting patients with community resources: these can include non-profit organizations that provide healthcare services to uninsured or underinsured individuals.
- Offering payment plans: work with patients to set up payment plans or other arrangements to make healthcare costs more manageable.
By taking these steps, providers and health plans can help ensure that patients who have lost Medicaid coverage are still able to access the care they need and avoid the negative health impacts that can result from a lack of healthcare coverage.
Amanda Minimi
Amanda Minimi is Director of Corporate Development at Aeroflow Healthcare.
