States Employ Tech to Overcome Medicaid Redetermination Challenges

States are employing tech vendors to help facilitate communications for the Medicaid redeterminations process, but they can’t curb the high volume of enrollees losing coverage.

More than 90 million Americans must undergo eligibility review over the next several months and the U.S. Department of Health and Human Services has estimated that more than 15 million people will lose Medicaid coverage.

Modern Healthcare reports that states are struggling with staffing, funds and outdated technology challenges that heighten the issues with data interoperability between Medicaid agencies. But some state programs like the Arizona Health Care Cost Containment System (AHCCCS) are employing tech like web-based chatbots to counter some of these challenges.

AHCCCS has also partnered with community health groups to assist enrollees with updating their contact information and other aspects of the renewal process, the Washington Post reports.

Thus far, more than 600,000 Americans have lost Medicaid coverage since pandemic protections ended, KFF Health News reports. The majority of people who have lost coverage did so because of technicalities, not because they were determined to no longer meet Medicaid income limits. Arizona is one of only two states reporting more losses due to confirmed eligibility than coverage ending for procedural reasons.

American Medical Association President Jack Resneck Jr. published an  explainer on the redetermination process that includes an explanation on the special ACA enrollment period and projected Medicaid program losses.

An article in the National Review called the redetermination period “common sense” in order to ensure that Medicaid remains a welfare program for low income people. The article highlighted the $99 billion in improper payments made by Medicaid in 2022.

The Centers for Medicare and Medicaid Services (CMS) announced the creation of the Managed Care Group within the Center for Medicaid and CHIP Services. Inside Health Policy reports that the group will take point on Medicaid managed care “access and accountability.”