Regular Medicaid coverage re-determination may resume in 2022, so providers may see many patients lose or change coverage.

Although this may create uncertainty for providers and patients, healthcare entities can help patients access resources and guide them into alternative coverage, and minimize disruption to their care.

Urban Research Institute estimates After the Medicaid enrollment reached a record high during the COVID-19 pandemic, approximately 15 million people will withdraw from the Medicaid program when they decide to restart.state Pause for re-decision In order to obtain more federal Medicaid funds during ongoing public health emergencies. As the pandemic continues, this state of emergency may be updated, but if Congress passes the “Better Rebuild Act”, a new decision may be restored next year. Domestic policy legislation includes a provision that allows states to review their Medicaid roster as early as April, even if a public health emergency declaration is in effect.

“This is an important cooperation opportunity for the entire health care sector and requires action by the federal government, states, health plans (and) health care providers to ensure that it can be done in the most thoughtful and supportive way,” said Alice Lin, Managing Director of Manatt Health.

Matt Salo, executive director of the National Association of Medicaid Directors, said that policymakers are concerned about how re-decisions will affect beneficiaries, but providers may also face challenges.

The fewer people with health insurance, the lower the utilization rate, the more unpaid medical expenses. The impact on provider reimbursement depends on how many people start Medicaid and actually find another source of coverage. The Urban Research Institute predicts that about one-third of adults in this group should be eligible for subsidized insurance from the Health Insurance Exchange, and many more will receive employer-sponsored insurance. Jennifer Talbert, director of state health reform for the Caesars Family Foundation, said that in some cases, the exchange program pays providers more than the Medicaid program.

But many people who qualify for Medicaid may lose benefits due to procedural issues, even if they are still eligible based on income, and not everyone who can receive an exchange subsidy will participate in the plan. “We kind of think it’s a bit like the Medicaid cliff,” said Shyloe Jones, senior manager of health equity at Families USA.

Overall, more people may be uninsured Community health center Budget and Increase medical costs Jeremy Crandall, director of national affairs for the National Association of Community Health Centers, said that in a comprehensive way. “The fewer insurance options our patients have, the more difficult it is for our medical centers to provide vital care to our patients,” he said.

Tricia Brooks, a professor at Georgetown University’s Children and Family Center, said providers can alleviate this situation by linking patients to resources for re-decisions or exchange registrations.

Many hospitals and community health centers have staff specifically helping to enroll in insurance, but the providers of individual clinics can also guide their patients to complete the expected work. Brooks said that the medical office can set up a phone, and people can call the Medicaid program directly to update their information or mail registration forms in batches on behalf of patients.

She said the Medicare and Medicaid Service Center can also simplify the process for providers and patients by allowing providers to update beneficiary contact information based on the patient’s oral certification.

Brooks said providers have financial incentives to ensure that patients get insurance.Although helping patients who need insurance can increase Administrative burden And costs. If they don’t have insurance, they will lose a large part of their patients.Countries can use funds from the United States to support these efforts U.S. Rescue Plan Act, she says.

After re-determination, providers may encounter patients who do not know that their Medicaid benefits have lapsed. Brooks said providers will hear stories about the patient’s experience in the redefinition process, and they can help decision makers improve the system by collecting and reporting that feedback.

President Joe Biden’s government will allow states One year After the public health emergency is over, the restoration will be re-determined on a regular basis. However, some state laws require a new decision as soon as possible.

Jeriviti, CEO of the Healthcare Finance Corporation, said that not all insurance coverage is equal, but getting people to participate in some kind of insurance will reduce the impact of people losing Medicaid. The company signs contracts with suppliers to assist patients. Participate in a welfare plan. “If we can increase coverage by letting people go through different doors, I think this is a mitigating factor,” he said.