Health Care System Digital Liberation and Enrollment Recovery

The Medicaid managed care organization (MCO) was losing members erroneously as part of Medicaid unwinding after the Public Health Emergency.  The MCO engaged Agilian to help them recover and retain members in long-term care, as well as to provide strategic plans for longer term initiatives and member retention results via our Value Delivery Office (VDO) and Organizational Learning services.

Result: Within 6 weeks of starting the engagement, Agilian was able to identify a segment of membership who were being unnecessarily lost during annual redetermination and provide persuasive evidence and supporting documentation for the MCO to take to the state’s eligibility response team, thus ensuring that those members could be recertified and retained.