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Health Plans Medicaid

3 Ways to Prepare for Medicaid Redetermination, Now

The U.S. extended the COVID-19 public health emergency once again, delaying the Medicaid redetermination trigger.      

Industry experts are raising alarms about what could happen to some of our most vulnerable populations once the current public health emergency ends and the annual redetermination process begins. The stakes are high, with 83 million Medicaid and CHIP enrollees at risk of losing coverage. And while you know that recertifying members hasn’t been required since early 2020, there are things you can do now to get ready for redetermining eligibility and keeping people covered.  

A crucial first step to redetermination? Reaching members where they are and explaining why it is so important for them to complete. Here are 3 tips for easing the redetermination process and keeping more members enrolled. 

1. Don’t wait: start planning your member engagement outreach now 

Time is ticking! Use this time to prepare recertification outreach strategies. Effectively reaching millions, or even thousands, of members is challenging, but you don’t have to do it alone. Find a trusted partner now to start building targeted outreach lists, create messages and supporting materials, and identify which outreach channels you’ll use. Preparing these things now–before the emergency period ends–means you will be ready when the time comes in January.  

2. Customize your outreach: data can help you identify members at high-risk of losing coverage

 It’s always been a challenge to get members to recertify, but some members are at higher risk for losing their coverage than others. The right partner can help you supplement your claims and clinical data to identify high-risk members with SDOH and consider predictors like education level, credit score or home ownership. With this information you can save time by creating prioritized lists for targeted outreach. For example, predictive models will indicate that Maria is likely to complete the process after one outreach, while Sarah needs an additional phone call or text message reminder to act. 

3. Multi-channel outreach: engage people where they are 

Since most of us own mobile phones, it’s no surprise we use them to text every day. Stats suggest people spend more than four hours a day on their phones, so your texts are very likely to be seen promptly.  Adding channels like text messaging into your campaigns is a proven way to boost reach because 90% of text messages are read within the first 3 minutes. Plus 2 out of 3 low-income Americans have used their phone to access health information, so you’ll be reaching members where they are. Be sure your messages include clear, simple instructions and help them complete actions by including click- through links and phone numbers for more information complete actions by including click- through links and phone numbers for more information. 

Reaching and engaging Medicaid members is a long-standing challenge, but it’s something Virgin Pulse has specialized in for over a decade. We have the data, analytics, multi-channel outreach, and expert strategists on staff to help you design outreach campaigns to ease the upcoming recertification process. Want to learn more? Let’s talk! 

Additional Content:

Medicaid Redetermination: 5 Reasons Why Texting is Essential for Reaching Members Before It’s Too Late

Member Experience Toolkit

The Health Plan of the Future: What Older Americans Want