Centene bracing for 2.2 million member loss in Medicaid redeterminations

Centene expects to lose millions of members in the redeterminations process and is focused on shifting members no longer eligible for Medicaid coverage to its marketplace offerings, executives said on a Feb. 7 investor call transcribed by Motley Fool. 

The company expects to lose 2.2 million members over the next year and a half through the redeterminations process, CFO Drew Asher told investors. 

CEO Sarah London said the company has three focuses approaching Medicaid redeterminations, which are set to begin April 1. 

December estimates from the Urban Institute and Robert Wood Johnson Foundation show that up to 18 million people could lose Medicaid coverage when continuous coverage requirements established during the pandemic end. 

The first of Centene's strategies is optimizing the verification process for Medicaid members, including using modeling to prioritize which members to reach out to first about enrollment. 

The company is also focused on ensuring state reimbursement rates reflect changes in the risk pool when members disenroll, Ms. London said. 

The company expects 200,000 to 300,000 Medicaid members in 25 states could shift to its exchange products. In 15 states where the payer has Medicaid contracts and exchange offerings, it will reach out directly to members with marketplace options, Ms. London said. 

Centene has over 15 million members in Medicaid managed care contracts in 29 states. 

State partners have been open to Centene's outreach and communication efforts to members ahead of redeterminations, Ms. London told investors. 

"In general, I feel like the industry is aligning and organizing around an approach that will minimize or seek to minimize member abrasion in the process and are allowing us to run alongside our state partners, all of which is positive from our perspective," she said. 

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