How 4 health systems are preparing for Medicaid redeterminations

Medicaid redeterminations begin April 1, but Renton, Wash.-based Providence's preparations date to last year. 

"As an organization, we started preparing for Medicaid redetermination almost a year ago because we know health insurance coverage is an essential social determinant of health and foundational to ensuring equitable access to care," Whitney Haggerson, Providence's vice president of health equity and Medicaid, told Becker's. "We knew from reports at the time that our most vulnerable communities could be disproportionately impacted by coverage loss if they do not know or understand the process they need to follow to reapply or find another option for healthcare coverage. We are hopeful that our efforts will help our patients stay covered."

In anticipation of the unwinding period, Providence launched a series of communications designed to ensure Medicaid patients across the seven states it serves are aware of the actions they must take to reapply, a Providence spokesperson told Becker's

Providence is providing information on alternative healthcare coverage options should patients no longer qualify for Medicaid. This includes information on ACA plans via state exchanges and information regarding the health system's financial assistance program. The spokesperson said the communications are available in several languages. 

Providence has also prepared for the unwinding period by developing education and training resources for front-line staff, including community health workers and financial counselors. The system has also developed partnerships with community-based organizations and payers at the local level and developed a digital tool to help with patient outreach and financial counseling appointment scheduling. 

A specialized set of financial counseling staff was specifically trained to work with Medicaid patients throughout the redetermination process. 

On the East Coast, Philadelphia-based Temple Health told Becker's in a statement that its financial counseling team is preparing to provide patients with information and assist them in completing renewal forms, as well as gathering and submitting necessary documentation. 

The health system said it is partnering with the Pennsylvania Department of Human Services to provide information to patients. Fliers and posters provided by the department will be displayed and distributed throughout Temple Health's physician offices and hospital campuses. 

Temple Health said it has also developed letters to provide Medicaid patients with information about the renewal process, contact information for county offices and change centers, as well as contact information for the health system's financial counseling team. 

The health system said its recent EHR/revenue cycle implementation has provided the technology to assist in its efforts. They can easily identify patients with Medicaid coverage through the system and have planned the following outreach efforts: 

  • Beginning in April, when Medicaid patients arrive for scheduled visits, staff are prompted to provide them with the aforementioned letters.
  • Patients enrolled in MyChart who have Medicaid coverage will receive these letters electronically through their MyTempleHealth account. If they are also enrolled in text messaging through Temple Health, they will also receive the notice via text. 
  • When scheduling patients with Medicaid coverage (via phone or in person) for physician visits, staff will be prompted with scripting providing information about the renewal process and providing contact information for financial counseling.

Financial counseling staff will be available to help patients who miss renewal deadlines to file appeals when possible or assist them in reapplying for coverage. 

"We anticipate that a significant number of patients will no longer qualify for ongoing Medicaid due to their current income and/or citizenship status," the health system said. "For these patients, financial counselors will assist with marketplace plan enrollment, Temple Health charity care/financial assistance applications, as well as referral to city health centers and Federally Qualified Health Centers for care." 

Livonia, Mich.-based Trinity Health told Becker's it has been preparing for the start of redeterminations in multiple ways. It has developed a systemwide campaign to raise awareness and provide support to patients in need of enrollment assistance. The campaign can be customized by each of its local systems to meet the needs of their specific markets. 

Outreach to patients will take place by email, MyChart, community health worker outreach and vendor partners, Trinity said in a statement. Information and resources are also available through websites, social media, at appointments and throughout patient-facing areas of its facilities. 

Michael Gustafson, MD, president of Worcester-based UMass Memorial Medical Center, told Becker's the system is increasing the number of employees on its financial counseling team to assist patients who may see a loss of coverage.  

"This is a substantial amount of work that needs to be done," he said. "We are staying current with all communications from MassHealth [Medicaid], Mass Hospital Association and CMS. We are also working to identify patients who will be part of the MassHealth redetermination process and developing both targeted and broad communications to inform them of potential changes to their plans."

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