In mid-2022, only a little more than a third of enrollees had awareness of the unwinding of the Medicaid continuous enrollment requirement based on analysis conducted by the Urban Institute. As awareness of the resumption of Medicaid renewals and disenrollments is increasing, some enrollees are getting anxious. And the best way to help quell their anxiety and avoid calls flooding call centers to check their status is to let enrollees know which month they are slated for renewal and to clearly communicate that renewals will be staggered over time.

There are a variety of ways that states can share renewal month with enrollees and frontline organizations who serve Medicaid enrollees. But states should not forgo sending direct mail to enrollees telling them which month their renewal will be processed and when they should look for renewal information from the state agency. Early communications can help mitigate confusion if official notices are unclear.

Online Accounts

Except Alaska, Mississippi, and New Jersey, all states have online Medicaid accounts that offer a timely and cost-effective way for states to communicate with enrollees and let them know which month their coverage will be renewed. It’s important to note that not all enrollees register for online accounts, so states should deploy multiple strategies to inform enrollees and frontline organizations that serve them of renewal dates.

Rhode Island’s renewal report indicates that the state has updated its mobile app and online portal to show enrollmees when their renewal is due and when the state will send the renewal packet.

Provider Portals

States have portals that allow health care providers to access certain information relating to patients with Medicaid coverage. This is a great way to share enrollee renewal dates that can be relayed to patients when they receive services. Some stakeholders seem to think that sharing renewal dates would violate privacy rules under HIPAA (the Health Insurance Portability and Accountability Act) and therefore is a barrier to sharing this information. HIPAA doesn’t apply to Medicaid agencies but nonetheless, health care providers can’t share protected health information with others beyond the patient without consent. HIPAA should not be a barrier to states providing renewal dates to providers.

Tennessee notes in its renewal report that providers can look up patient renewal dates in an online portal to inform patients of when their renewal will be processed.

Assister Portals

Over half of the states (29) have assister portals that allow navigators, health care providers, and authorized community-based organizations to facilitate enrollment and renewal on behalf of enrollees. Providing renewal dates in assister portals offers enrollees another channel to check their renewal date and allows assisters to proactively reach out to help enrollees complete the renewal process.

Managed Care Organizations (MCOs)

States have been encouraged to engage Medicaid managed care plans in outreach and assistance to their members during the unwinding. If states provide advance lists of members that are coming up for renewal to MCOs, as two-thirds of states plan to do, it will help for MCOs to follow-up with enrollees up for renewal and offer assistance. Even more helpful would be for states to provide the full year’s scheduled renewals. Plans could then undertake broader efforts to share renewal dates with members.

Communications

States can also quell anxiety through clear communications using multiple channels to reach enrollees. First, many enrollees are not aware that states may automatically renew coverage through ex parte processes. The share of renewals successfully completed via ex parte varies significantly across states but in states with higher rates of ex parte renewals, it’s helpful for enrollees to understand that they may not be required to respond to a renewal request. States should also emphasize in communications that renewals will be staggered and over what period time.

Arizona is considering using software that would auto-notify enrollees via text and email when a renewal is coming due in a future month.

Social and Traditional Media

When the Urban Institute analyzed awareness of the unwinding (referenced above), they found that the most prevalent source of information was social or traditional media, followed by information received directly from the state. States should take heed that social and traditional media outreach can supplement state communications and amplify key messages. Monitoring social media can also help identify opportunities to clarify inaccurate information during the unwinding. 

A Dedicated Hotline Option

I know state capacity is stretched but a dedicated hotline or option within a state’s interactive voice response system to check your renewal date could offload from call centers and avoid extensive call center wait times for families whose jobs don’t permit them to stay on hold for extensive lengths of time. In the long run, having dedicated access to checking your renewal month could be a great way to efficiently allocate limited state resources.

All of the Above

No one strategy deployed by any state will reach everyone who needs to hear the message. States should think broadly about alerting, without alarming, Medicaid enrollees that processes are changing and how it may affect them. Providing multiple ways to communicate renewal dates and what to expect during the renewal process can help contribute to more favorable renewal outcomes during the unwinding.

[Editor’s Note: For more information, visit our PHE Unwinding resource page where you’ll find other blogs in this series, reports, webinars and the 50-state tracker.]