Thursday, May 2, 2019

Medicaid Churn Adds Burden to Health Plans


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.

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