6 ways states are addressing Medicaid staff shortages

State Medicaid agencies are facing staff shortages as they prepare to process Medicaid enrollment and eligibility verification for the first time in three years. 

According to a survey by Kaiser Family Foundation of all 50 state Medicaid agencies and the District of Columbia published March 21, the majority of states have a high number of vacant positions for staff determining Medicaid eligibility and at call centers. 

Starting April 1, states can begin disenrolling Medicaid enrollees for the first time since the COVID-19 public health emergency took effect in 2020. States surveyed estimated that around 18 percent of current Medicaid enrollees will lose their coverage. 

In seven states, eligibility staff vacancy rates are higher than 20 percent. In five states, call center staff vacancies are higher than 20 percent. 

Of the 47 states that responded to KFF's questions about staffing, 36 said they are taking at least one form of action to address staffing shortages. 

Here are six strategies states are using to shore up staffing as the continuous enrollment provision ends: 

  1. 30 states are planning to approve overtime for existing staff
  2. 25 states plan to hire new staffers
  3. 15 states plan to hire contract workers
  4. 14 states plan to temporarily rehire retired workers 
  5. 13 states will hire temporary staff for redeterminations 
  6. Nine states will borrow staff from other state agencies. 

In some states, Medicaid renewals are also processed by county agencies. KFF researchers noted in the report that it is less clear how counties are addressing staff shortages, but several states indicated they are providing more staff resources to county agencies. 

See the full report here.

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