Medicaid Continuous Enrollment Is Over — 4 Ways to Connect With the Hardest to Reach Populations

The moment has arrived: The pandemic-era provision that has allowed people to continuously remain enrolled in Medicaid has come to an end. With the return of annual state-by-state Medicaid redeterminations, between 8 million and 24 million people may lose coverage over the next year, according to estimates by the Kaiser Family Foundation. The Urban Institute, meanwhile, puts the figure at around 18 million over 14 months.

Based on data from previous years, as many as 7.9% of these enrollees will still qualify for Medicaid, but they may be unaware that they need to reapply — and this is a notoriously difficult population to reach. The result? If they don’t receive the message about reapplying in time, they will be automatically disenrolled.

Here’s what makes this situation doubly difficult: Talking redetermination is, even in the best of times, no easy task. Medicaid is complex, and simplifying it for a vast and varied population is a tall order. Add to that the frequently shifting information about this program’s end dates, the fact that no plan relishes delivering unfortunate news to a member (the words “automatic disenrollment” don’t exactly make for pleasant messaging), and the many barriers that stand in the way of fruitful communication with the Medicaid-enrolled population, and you’ve got a tricky task on your hands.

But there is good news, in that the present moment presents a unique opportunity. Losing Medicaid coverage qualifies as a “life event,” allowing 60 days for people to enroll in employer-sponsored coverage or an alternate plan. Add to that that many people who previously didn’t qualify for an Affordable Care Act plan may now have low or no-premium options. As a result, plans that can provide simple, personalized information stand to not only retain members but also acquire new ones.

How? With a messaging strategy that simplifies and clarifies. Here’s your 4-step plan.

Step #1: Make it personal — and human

Private insurers crafting updated acquisition and retention strategies will need to identify the population segments to whom their organization can be most helpful, and target communications accordingly — including a full rundown of the benefits likely to matter to them and the potential risks of foregoing insurance.

That’s of particular value here, thanks to the complex nature of Medicaid in general and the extra wrinkles that members are facing now. And it’s likely to go a long way if plans are up front and honest about how complicated these programs can feel — to acknowledge the complexity members are facing and promise to help demystify the next steps.

When a potential enrollee is looking for guidance on their healthcare options, they’re not interested in boilerplate information that may not speak to their particular circumstances. They want real-world intel on what they can expect if they allow their coverage to lapse. What is the true cost of being uninsured? How does that cost change for those living with chronic conditions? What are the specific changes where they live? A dynamic, scalable content platform, whose communications are triggered by specific moments in a member’s healthcare journey, can make a massive difference in members’ engagement level and benefits literacy.

With the pressing need for personalization in mind, can your organization adopt a technological solution to help prospective members figure out the best plan to suit their health needs, budget constraints, and family situation, be it coverage through their employer, an Affordable Care Act marketplace plan, Medicare, or your organization? Plans must meet people where they are and tell them what they need to know — which just so happens to be a surefire way to show them you’re an authority they can trust.

Step #2: Double down on engagement

For plans that service Medicaid recipients, now is the time to overdeliver on member engagement. The more you can explain what’s about to go down, the better. Recall that stat on the knowledge gap regarding the return of redetermination — a full 62% had no idea these changes were on the way — and double down, or even triple down, on the information you’re sending members.

Make reapplication as easy on them as possible. Guide them directly to the site where they’ll need to submit their information. Tell them exactly what materials to have on hand while doing so. Offer one-on-one assistance with reapplication if you’re able. Given the seriousness of this situation, there’s no such thing as too much communication right now.

Meanwhile, make sure prospective members aren’t being inundated with the wrong information — or the same information again and again. Instead, craft their calls to action to be directly pertinent to their needs and guide them to the next step in their reapplication journey.   

Step #3: Culture and language matter

Among those most likely to be affected by the return of redetermination are people with limited English proficiency, who make up a disproportionate share of the Medicaid-enrolled population. The Kaiser Family Foundation notes that more than 70% of this vulnerable cohort is categorized as Hispanic.

As you review your outreach and engagement strategies, offering written communications in both English and Spanish is now table stakes. Does your plan offer customers the option of a bilingual customer service representative? Does messaging integrate cultural insights to maximize relevancy and guide members toward further assistance? Have you consulted with an expert in culturally competent engagement to help get the word out to those who desperately need it?

The Department of Health and Human Services offers guidance to help plans do just that, delineating the precise responsibilities that Medicaid servicers have in terms of accommodating members with limited English proficiency. Now is a great time to make abundantly sure that you’re in compliance with those requirements — and to go above and beyond them if possible.

Finally, are you ensuring that your information is appropriately distilled and simplified, to make an impact on as many people as possible? If a prospective member isn’t well versed in the intricacies of health plans and how they function, they may be left behind by content that is too academic in tone. It’s your job to make sure this doesn’t happen.

Step #4: Multichannel is a must

To deal with this massive disruption in Medicaid enrollment, healthcare plans will need to hone a strong, compelling voice to stand out from the deluge of generic messaging that will likely accompany it. But just as important is the diversity of touchpoints and your ability to meet members and potential members where they are. That means a truly multichannel approach is a must.

For example, Linkwell Health’s engagement solutions include high-performing omnichannel journeys via email, social media, content-rich digital destinations, print newsletters (in both English and Spanish), and SMS text messaging. This last method has been shown to be a particularly effective channel for hard-to-reach populations, since 85% of Americans own a smartphone, including 75% of those who earn less than $30,000 per year, per Pew Research.

Keep in mind that health plans have been revving their engagement strategies for months in anticipation of this moment, but for members the fallout might not be addressed immediately. So, it’s wise to apply a long lens to your outreach efforts to best capitalize on the long-tail potential of this unprecedented event, as millions of people on Medicaid are disenrolled from coverage and will need information and resources about re-enrollment.

It’s also never a bad idea to enlist help in these efforts. Linkwell Health has proven experience engaging hard-to-reach populations and we offer a targeted redetermination solution that includes a fully branded, configurable digital experience with high-performing content and targeted calls to action to drive desired behavior change.

Contact us to learn more.