How CVS, Walgreens are the front door to Medicaid redeterminations

The nation's retail pharmacy giants are playing an important role in Medicaid redeterminations through payer-agnostic outreach and education initiatives aimed at customers and employees in all 50 states.

States could begin terminating coverage for ineligible Medicaid recipients in April following a three-year period of continuous Medicaid/CHIP enrollment under the COVID-19 public health emergency.

Walgreens

On June 13 at AHIP's 2023 conference, Walgreens Boots Alliance CEO Roz Brewer detailed how the company is educating customers and employees about the ongoing process at 9,100 stores in the U.S. She noted that the company's pharmacists and technicians have always been trained to locate and find new insurance plans for customers during traditional open enrollment periods.

"Right now we're doing a lot more to educate and partner with Medicaid to make sure that in these gaps and periods of time, people have the ability to understand what the changes are," she said. "Our team does a lot of work in that space so we can be that first responder when these questions surface because it happens right in our stores. The insurance will change or drop, and we need to know how that happens." 

On the pharmacy side, Ms. Brewer said the company is looking to provide pharmacists with "the ability to test and treat in the stores so that when this insurance piece gets upside down and not understood, [customers] still have someone that can care and deliver for them in that time frame."

"We're always looking at all the patients that are on a 90-day supply plan, for instance, and making sure those callbacks are happening so that if the insurance is gapping, at least they know when their next deliverable is," she said. "We really beef up for those times, and this time right now where things are very uncertain."

CVS Health

Kelly Munson, president of Aetna Medicaid, a CVS Health company, told Becker's in March that CVS' 9,600 retail stores have a chance to reach all Medicaid members when they walk into a store, regardless of if they are members of Aetna or another managed care plan. 

"We happen to have something extra special in our CVS ownership in that we've been able to work with our CVS partners and the way they can support Medicaid on the whole," she said. "Regardless of payer, CVS can be supportive of all the Medicaid members that are walking in the door. We have messaging in the stores that plays over the sound system, videos that remind members they need to be looking for redeterminations, and we have QR codes they can scan so they can know and understand what their next move is."


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