5 key strategies states are using for Medicaid redeterminations

While state approaches to Medicaid redeterminations can vary widely, most states are adopting a few key strategies to promote continuity of coverage, according to a report from Kaiser Family Foundation. 

The foundation published results of a survey of all 50 state Medicaid agencies, and the District of Columbia. Not every state agency responded to every question. 

Beginning April 1, states can disenroll Medicaid members who are no longer eligible for the program for the first time since the beginning of the COVID-19 public health emergency in 2020. 

Kaiser Family Foundation estimates around 15 million people will lose their Medicaid coverage during redeterminations. Around one-third of the state agencies KFF surveyed provided an estimate of how many Medicaid beneficiaries would be disenrolled. Among those who did respond, the average estimate was 18 percent. 

Here are five key strategies states are using during the redeterminations process: 

  1. Forty-three state Medicaid agencies estimated they will take the full 12 to 14 months allotted to complete the unwinding process. Five states estimated the process will take nine to 12 months, and one state, Arkansas, is planning to complete the process in just six months. 

  2. Most states are taking steps to expand "ex parte" renewals, where beneficiaries do not have to re-verify eligibility themselves. Thirty state Medicaid agencies said they are taking steps to expand ex parte renewals to more beneficiaries, and 30 states also said this process is mostly automated. Additionally, 18 states said more than half of their renewals will be ex parte. 

  3. A majority of states are prioritizing renewals based on multiple factors, like time since last renewal and likelihood of ineligibility. Of the state Medicaid agencies surveyed, 12 said they are using a time-based approach, which will schedule renewals based on the date last renewed. 

  4. Almost every state is using multiple strategies to ramp up outreach to Medicaid enrollees. Forty states will take steps to contact enrollees if mail to their address is undeliverable, and 35 state agencies said they will follow up with enrollees when action is needed to complete their Medicaid renewal. Additionally, most states are partnering with managed care organizations running Medicaid programs on outreach efforts. 

  5. Less than half the states are currently planning to publish Medicaid unwinding data online — of the states that responded to this question on KFF's survey, 23 said they would publish data online, four said they would not publish this data, and 22 were undecided. 

Read the full report here. 

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