By Jane Anderson
Newly implemented state paperwork requirements caused around 1.6
million Medicaid beneficiaries to lose coverage in 2018, the advocacy group
Families USA says.
State policy decisions to engage in more frequent eligibility
redeterminations are responsible for a large part of the enrollment drops,
particularly in three states: Tennessee, Arkansas and Missouri, according to
the group’s report, "The Return of Churn."
Federal law and regulations require state Medicaid agencies to
renew beneficiaries' eligibility determinations every 12 months. However,
Families USA says some states make this process much more difficult than
others, with barriers including significant paperwork requirements and a lack
of online enrollment options.
"A health plan's onboarding process for a new member
involves considerable paperwork," says Meg Murray, Association for
Community Affiliated Plans CEO. "This involves significant administrative
and overhead costs that would be avoided were a member to be continuously
enrolled."
Increased churn may also result in reduced revenue streams for
Medicaid plans where beneficiaries are being dropped from the rolls in large
numbers, says Gerard (Jerry) Vitti, founder and CEO of Healthcare Financial,
Inc.
"The most vulnerable members are those who are the least
able to comply with these onerous roadblocks they are teeing up," he adds.
If these beneficiaries lose coverage, they ultimately may cost the system more
money because they may end up with a hospital stay or emergency room visit that
might have been prevented, Vitti says.
Still, Alex Shekhdar, founder of Sycamore Creek Healthcare
Advisors, notes that enrollment of ineligible people is a significant problem
in Medicaid, and the redetermination procedures are designed to address that.
From Health Plan Weekly
No comments:
Post a Comment