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What 2023 Medicaid Redeterminations Mean for Your Hospital

May 24, 2023

As Medicaid officials commence the process of redetermining coverage and eligibility following the expiration of COVID-19 Medicaid policies, millions of patients nationwide face the peril of losing their health insurance. This development has exacerbated the already volatile healthcare landscape, leaving both patients and hospitals anxious. To help you stay informed, we’ve compiled the key facts you need to know about this ongoing issue.

What is Happening

As part of the COVID-19 public emergency, it was mandated through the Families First Coronavirus Response Act (FFCA) that patients and families would stay continually enrolled in Medicaid through the course of the public emergency’s declaration. Kaiser Family Foundation (KFF) estimated that Medicaid enrollments have quadrupled since the pandemic, rising from 23.3 million enrollees in February 2020 to 95 million in March 2023. However, as part of the Consolidated Appropriations Act, 2023, the continual enrollment period concluded on March 31, 2023, along with plans to begin reducing the heightened pandemic-era Medicaid funding. As state Medicaid redeterminations begin, the Department of Health and Human Services (DHHS) projects that up to 15 million Americans could lose their Medicaid coverage in the wake of these changes.

What You Can Do

To ensure Medicaid recipients are aware of the commencement of redeterminations and avoid losing coverage, both health systems and state departments have initiated communications and outreach efforts. This outreach has been spurred by state initiatives proposed by CMS for managing redeterminations. Given the urgency of the renewal process, timely messaging that reaches all segments of the population with clear communication is critical. However, since patients bear much of the responsibility for the reenrollment process, it’s equally essential for organizations to be prepared to respond to inquiries and share the necessary information to assist patients in navigating their eligibility.

How PRC Can Help

PRC is uniquely positioned to assist organizations with inbound and outbound call support for Medicaid redeterminations. With more than four decades of experience conducting healthcare research, our in-house call center is equipped to provide compassionate and effective phone communications, including a team of bilingual callers, who are trained to handle confidential patient information with the utmost care and in compliance with HIPAA standards. With our expertise and resources, we can help make the Medicaid redetermination and reenrollment process more manageable for both organizations and patients, walking Medicaid recipients through the steps necessary to ensure their continued enrollment. Indeed, at PRC, we’re ready and dedicated to providing exceptional support every step of the way.

Visit our call center webpage to learn more, and reach out today to speak with a PRC expert about how we can fulfill your call center needs.

Sources and Further Reading:
10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision

Health systems nervous as Medicaid redeterminations threaten shaky bottom lines

Why millions on Medicaid are at risk of losing coverage in the months ahead