Biden-Harris Administration Approves Continuous Medicaid Eligibility in Five States
The Biden-Harris Administration has approved Section 1115 Medicaid demonstration amendments for five states: Colorado, Hawaii, Minnesota, New York, and Pennsylvania, providing extended continuous eligibility for children and individuals leaving incarceration. This policy will improve health outcomes and reduce disparities by ensuring uninterrupted coverage for vulnerable populations.
Benefits of Continuous Eligibility
Continuous eligibility helps individuals maintain Medicaid or CHIP coverage without frequent renewals, ensuring access to vital health services like preventive care and mental health support. This is especially crucial for children, who are at risk of losing coverage due to income changes, and for individuals transitioning out of incarceration who often face healthcare gaps.
Key Benefits for Vulnerable Populations
Children’s Health: Continuous eligibility ensures access to regular check-ups, immunizations, and mental health services, improving both health and educational outcomes.
Support for Individuals Leaving Incarceration: Extended coverage helps this group manage chronic conditions and access mental health care, supporting successful reintegration.
Addressing Health Disparities: Continuous eligibility for low-income and minority populations helps tackle health inequities and improve public health.
How MCOs Can Leverage These Changes
Enhance Care Coordination: MCOs should collaborate with healthcare providers, community organizations, and state Medicaid agencies to create integrated care pathways for children and individuals transitioning from incarceration, ensuring seamless care and improved patient outcomes.
Utilize Data to Target Outreach: MCOs can use data analytics to identify eligible members and connect them with necessary care, providing personalized outreach based on demographic and health needs.
Invest in Member Education and Support: MCOs should launch educational campaigns to inform members about continuous eligibility, how to access new benefits, and navigate available services. Support groups and patient navigators can also help members maximize their coverage.
Focus on Health Equity: By prioritizing care for underserved populations, including children and individuals leaving incarceration, MCOs can contribute to reducing health disparities and ensuring all members receive the care they need to thrive.
A Call to Action for MCOs
The approval of continuous Medicaid eligibility in five states offers MCOs a chance to improve healthcare access and reduce disparities. By ensuring uninterrupted coverage for children and vulnerable populations, MCOs can help achieve better health outcomes. This change is an opportunity to engage members, optimize care, and focus on health equity. MCOs can lead by leveraging data, building partnerships, and educating members. Agilian is here to support MCOs by providing the tools and expertise needed to navigate these changes and ensure improved care and access for all. Now is the time for MCOs to embrace these changes and contribute to a more equitable healthcare system.