Summary
Expert CEO Samantha Olds Frey Talks Illinois Medicaid Health Plans and Healthcare Trends
Background and Redeterminations
Samantha Olds Frey, CEO of the Illinois Association of Medicaid Health Plans, recently joined an episode to discuss Illinois Medicaid policy and the impact it can have on people’s lives. She noted that the upcoming Medicaid redetermination process will have a significant operational impact due to retroactive claims and noisy data. Financial impacts for health plans and providers include potential losses from members becoming ineligible due to paperwork issues or changes in eligibility.
Impact on Safety Net Providers
Providers must prepare for a potentially increased acuity of their patient pool since younger members in better health may lose coverage. Safety net providers will still need to serve these patients but will not have Medicaid coverage. Providers should reach out to their patients and inform them how to update their address with the state, so they don’t miss their redetermination letter.
Health-Related Social Needs, Value-Based Care Transformation, and Partnership Successes
Illinois Health Plans are finding innovative ways to address the health-related social needs, value-based care transformation, and workforce shortages. For example, partnering with the Cook County housing pool has led to a decrease in hospitalizations, improved medication adherence, and increased stabilization.
Advice for Aspiring Healthcare Leaders
Samantha’s advice for aspiring healthcare leaders is to remain curious and compassionate. Partnerships are critical in addressing social-related health needs, and her organization is hosting a conference on partnerships in September.
Note: This is an AI generated transcript, not edited by a staff writer and is solely intended for educational purposes. If you have any questions/concerns, reach out to podcasts@beckershealthcare.com
This episode aired on 04/11/2023 and can be listened here.
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