In this second part of a two-part video series, Nathan Allen, Senior Vice President – Healthcare Provider Solutions at Firstsource, discusses Medicaid Redetermination for those who are Medicaid members, but are deemed to lose their coverage due to the upcoming expiration of COVID-19’s Public Health Emergency. Allen set a scope on Medicaid populations in rural settings and how they could be affected. However, there is hope through tech-based solutions and a proposed rule by CMS to prevent facility closures and preserve access to care for all affected Medicaid populations.
Nathan Allen, Senior Vice President – Healthcare Provider Solutions at Firstsource, discusses Medicaid Redetermination for those who are Medicaid members, but are deemed to lose their coverage due to the upcoming expiration of COVID-19’s Public Health Emergency. Allen set a scope on Medicaid populations in rural settings and how they could be affected. However, there is hope through tech-based solutions and a proposed rule by CMS to prevent facility closures and preserve access to care for all affected Medicaid populations.
Populations in rural settings are just as affected by the PHE expiration as others. What are some technology-driven solutions or programs? Any rural hospitals can benefit from?
0:10: What we’ve been talking to hospitals about is, well really the first step is the data integrity. Again states have not necessarily communicated with some of these people in two and a half years. So, as we know, people have moved around, you know, they might have a new address or a new telephone number and if states don’t have the best contact information to send these letters to conduct their outreach attempts it could fall on deaf ears. So, what we’re talking to hospitals about is as a first step, run some type of data integrity. If you have access to a skip tracing tool through like a LexisNexis or something like that, that can be beneficial. In many cases, we expect that hospitals will have better data than the states do because they’ve seen these people more frequently or more recently than the Medicaid offices have interacted with them. But I would say the first step would be to scrub that data for good contact information. Once you have that good contact information, as I mentioned before, using omni channel outreach, text messaging, emails, just really any channel that you can use to reach out to these people.
1:21: A light touch could just be an educational message letting them know that the PHE has been lifted, and there’s action required on their part to maintain their coverage.
1:32: Maybe a reminder to look out for notices from Medicaid, something like that. And then as I mentioned before, as well, offering that high touch advocacy if you’re able to provide resources to talk to your Medicaid population, that can be really helpful in making sure that they’re educated and able to go through the process of reenrollment.
2:00: You know, the other part I would mention is, how you how you segment your outreach efforts, you know, some of these hospitals in rural areas might be seeing the same patients over and over, that might be a higher priority to try to reach out to from a high touch perspective then, you know, if you saw a patient maybe 18 months ago and they haven’t been back to your facility. So those are just a few things that that we’re talking to hospitals about and in offering our support as much as we can to be able to assist with those efforts.
CMS has proposed a rule to prevent facility closures and preserve access to care. Can you address this and how it will affect patients?
2:39: Look, I live in a rural area, so I experienced this. My daughter is a type one diabetic and she was diagnosed last summer. And when we had to take her to the hospital, you know, we had to drive an hour into, you know, a bigger city where they had a children’s hospital. So, access to care is to me what this is all about and making sure that people in a rural community have access to care. I saw a release that since 2010, 138 rural hospitals have closed and you know, with the public health emergency, you know, funding issues, budget issues, things like that. I think that this is CMS’ attempt to make sure that rural hospitals are not closing and that they’re staying open and able to even expand patients’ access to care, which you know, if you live in a rural community, which I think one in five Americans do, that’s something that probably would resonate with you as a consumer of healthcare.
Previous article: Part 1, Medicaid Redetermination Solutions for Members Deemed to Lose Coverage From PHE Expiration