As Medicaid redeterminations take place nationwide, some states have been terminating coverage for more than a month, including Arizona.
At Blue Cross Blue Shield of Arizona, about 60,000 of the company's 245,000 Medicaid members are at risk of losing coverage. Becker's spoke with Marla Bauer, director of growth and marketing for the payer's individual ACA business, to understand how the company is navigating redeterminations and steering disenrolled individuals toward other coverage options.
Across Arizona, an estimated 600,000 people are at risk of losing Medicaid coverage. Internal BCBS projections say 40 percent will remain covered through Medicaid, and about 19 percent could remain uninsured entirely.
Other recent estimates have said Arizona's uninsured population will grow more than 20 percent by June 2024 to reach a total of 733,000 people.
The majority of states will begin terminating coverage in June and July.
Question: What do your ACA offerings look like to meet this challenge?
Marla Bauer: Our product team is really knowledgeable and understanding of our consumer market and what they're looking for. We offer six different types of ACA plans that fit different health needs and different budgets, with varying deductible levels. They range from those that have chronic conditions, to those that are really healthy, and those that have families and children that go to the pediatrician a lot. What our teams do is try to make it as simple for the consumer as possible because they know that healthcare is confusing and trying to select a plan is pretty daunting.
In Arizona, we're the only ACA plan that's offered statewide, with some counties where we're the only carrier. We're doing a huge statewide education effort to get these folks who are at risk of losing Medicaid to understand what's happening and to make sure that they are paying attention so that they don't have a gap in care. We're then directing them to either our Medicaid division so that they can update their eligibility information, or moving them over to our ACA plans or Medicare.
Q: How long have you been preparing for redeterminations?
MB: We've been working on this for at least a year and a half now; it kept getting delayed in terms of the timing and when they were going to start the redeterminations. It started off with our core Medicaid division, who works closely with AHCCCS, the state's Medicaid program. We needed to understand what they were going to do, how they were going to disenroll, how they were going to notify individuals, and what kind of data we would get from them regarding our membership. They started over a year ago with trying to get people to update their information.
There was one example of a member who within the three years during COVID had moved locations three times and changed his cellphone number twice, so trying to contact these folks is very challenging. Our teams are doing outreach via phone, text messaging, emails and direct mail to get information up to date and prevent accidental disenrollments. The teams have also been working with our contracted providers to marry the data together to get the most accurate information, along with educating providers so that when these patients come in, they know what's coming and to get their information up to date.
Q: Arizona is one of five states that began terminating Medicaid coverage in April. What has that experience been like for BCBS?
MB: We've really come together. We have a daily standup where we talk about new insights on calls that have come in or updates from AHCCCS and CMS. When those things pop up, their teams and our team are very connected in terms of supporting members through disenrollments and getting them to somebody to talk about ACA plans. We try to hold the member's hand as much as possible because in the end, it's about the members.
Q: What's your best advice for payers in states that haven't started terminations yet?
MB: Make your staff aware. If a member or patient comes in, make sure there's an alert that says they're on Medicaid with any systems or tools you're using so that person knows what things they need to consider. Every touchpoint needs to help people become aware of their current situation — the data and the information are available.
A lot of us are worried about the children on Medicaid and that they're going to get lost in the shuffle. Children need to get routine care such as their wellness checks and vaccinations. It all comes down to making sure that every time we're talking to somebody, whether they're at the hospital, the pharmacy, or calling their carrier, that everyone knows what's happening to this population and to help them through it and give them some peace of mind.