Gross Medicaid and CHIP cuts total $990B over ten years, the largest reduction in program history.
H.R.1
When Coverage Gets Harder to Keep, Your Patients Need You More.
H.R. 1 is now law. Be ready to help patients stay covered while protecting your revenue.
H.R.1 Changes the Rules. Your Patients Will Feel the Impact.
The largest Medicaid restructuring in decades is already in motion
The answer isn't simply managing new rules. It's helping patients navigate them.
Redeterminations, work requirements, shrinking retroactive windows, and tighter accuracy standards are landing all at once, asking more of patients in deadlines and documentation.
Most patients who lose Medicaid won't lose it because they're ineligible, they'll lose it because the process was too hard to navigate.
That hits hospitals too: shrinking back-billing revenue, compliance risk from verification errors, and added operational complexity.
Protecting patient access means acting now: identify affected patients, educate them, and help them complete required steps before coverage is at risk.
Our Solution
Four ways to stay ahead of coverage loss
Four coordinated areas of intervention, one connected system. Firstsource's H.R. 1 solution combines Voice AI, SMS, predictive analytics, and trained navigators to help health systems identify risk early, engage patients proactively, and manage the full patient lifecycle through this transition.
Reach patients before coverage deadlines hit.
Multi-channel outreach (Voice AI, SMS, and email) reaches patients at scale before their coverage deadline, with state-specific messaging explaining exactly what's changed and what action is required.
Multi-channel outreach (Voice AI, SMS, and email) reaches patients at scale before their coverage deadline, with state-specific messaging explaining exactly what's changed and what action is required.
Gather documentation before the state asks for it.
Trained navigators help patients document qualifying activity before deadlines arrive, tracking eligibility data and work-requirement evidence now, so patients aren't caught off-guard later.
Trained navigators help patients document qualifying activity before deadlines arrive, tracking eligibility data and work-requirement evidence now, so patients aren't caught off-guard later.
Keep enrolled patients informed so coverage doesn't lapse.
Once patients are enrolled or re-enrolled, ongoing outreach keeps them informed of renewal timelines, work requirements, and process changes, reducing future churn and re-outreach costs.
Once patients are enrolled or re-enrolled, ongoing outreach keeps them informed of renewal timelines, work requirements, and process changes, reducing future churn and re-outreach costs.
Flag grace-period risk before it becomes a claim problem.
Real-time monitoring flags ACA grace-period status before billing occurs, allowing early intervention to prevent denied claims and clawbacks.
Real-time monitoring flags ACA grace-period status before billing occurs, allowing early intervention to prevent denied claims and clawbacks.
Two Tracks, One Goal: End-to-End Coverage Protection.
H.R.1 is reshaping how patients qualify for and keep their coverage. We help you manage that shift across the entire patient lifecycle, from prevention to recovery. Our approach runs two coordinated tracks. Once enrolled, patients stay in our education and monitoring system for ongoing communication about renewal dates, work requirement changes, and process updates.
Educate & Protect
For Medicaid and ACA patients approaching coverage termination or redetermination
- Coverage discovery identifies patients within 90 days of coverage termination
- Omni-channel outreach delivers state-specific education
- Trained advocates are connected to patients needing enrollment support
Medicaid Screening & Work Requirements
For self-pay populations facing work requirements or redetermination deadlines
- Real-time risk detection flags grace-period risk and compliance errors early
- Trained advocates gather eligibility and work-requirement documentation, navigate state requirements and submit information on the patient's behalf
- Self-pay patients who screen positive for Medicaid are flagged for active outreach and enrollment assistance
Decades of Medicaid Expertise, Built for This Moment
40+ Years
of Medicaid and patient access expertise
500K+
Medicaid enrollments processed annually
$7.75B
in approved funding value recovered
800+
facilities nationwide relying on our operations
Experience
Experience across all 50 state Medicaid programs
Why Firstsource
Proactive by Design
We identify patients at risk before they self-identify, giving your teams more time to intervene.
One Connected Operation
Eligibility, outreach, work-requirement documentation, and denial management work together, rather than across disconnected vendors and workflows.
Outcome-Led Accountability
We measure success by what truly matters: sustainable coverage, revenue recovered, and compliance achieved - not activity metrics or contact counts. Our commercial model aligns with yours: you only pay for results.
Deep Industry Expertise, Embeded
Decades of experience, built directly into how we operate - accessible to your team through trained advocates, real-time guidance, and continuous learning at scale.
contact us
Let's Build Your H.R. 1 Action Plan.
Schedule a consultation with our experts. We'll help you assess your exposure and identify where targeted interventions deliver the most value.
- Tell us a little about your organization and we'll help you understand where H.R. 1 could create the greatest coverage, operational and revenue exposure.
- We'll help you identify the gaps that need attention first, prioritize the opportunities with the greatest potential impact and determine where targeted intervention can make the biggest difference.