The COVID-19 pandemic has impacted how healthcare is delivered nationwide and touches virtually every service that managed care plans provide to their members. At BeneLynk, our services have needed to adapt to this new reality. Possibly the most impacted area has been that of dually enrolled Medicare Advantage members.
BeneLynk’s Social Determinant of Health (SDoH) outreach helps dually enrolled Medicare Advantage members keep their Medicaid benefits. Advocating for members to maintain steady Medicaid enrollment gives the member important financial assistance and helps the Medicare Advantage plan to maintain appropriate capitation. We have also found that a well-run Medicaid retention program increases member loyalty to their MA plan and reduces plan disenrollment. Usually, a good Medicaid retention program is centered on outreach to a subset of the Medicare Advantage population every month communicating about upcoming requirements, securing necessary documentation, and providing members with needed assistance. At BeneLynk, our on-shore agents lead with help, engaging MA members, linking them with benefits, and helping them to navigate the Medicaid recertification process.
COVID-19 and the Public Health Emergency (PHE) declared by Department of Health and Human Services Secretary Azar in January of 2020 have complicated this picture. The Families First Coronavirus Response Act temporarily increases the federal Medicaid matching rate (FMAP) by 6.2 percentage points. However, to receive the increase, state Medicaid programs must meet Maintenance of Effort (MOE) requirements. The law does not require states to suspend renewals or periodic reviews, but they cannot disenroll anyone who was enrolled as of March 18th for any reason except for an out-of-state move or voluntary termination.
Different states are taking different approaches to managing their recertification process through the PHE. Some are continuing the Medicaid recertification process but are staying any disenrollments until the MOE requirements are lifted. Others have extended renewal periods or are only processing passive renewals that don’t require any participation from members, and still others have paused the Medicaid recertification process altogether.
The following table represents our understanding of the current approach of Medicaid administrations throughout the country:
At BeneLynk, we see this unique circumstance as an opportunity to display our commitment to flexibility. We need to understand the approach that individual states are taking. Even more importantly, we need to understand how our client, the Medicare Advantage plan, wants us to respond. A plan may want to continue outreach, letting members know that the recertification process is ongoing even while removals from Medicaid are paused. Or some plans may want to avoid new communications until the PHE is over.
Our first responsibility is to provide our client with the latest information. BeneLynk’s services create an ongoing channel for communication with a wide array of managed care members. When unique challenges like a nationwide pandemic strike, we are committed to a flexible approach that responds to the unique environment in each state and the particular approach that our Medicare Advantage clients wish to take. And of course, as soon as the PHE ends, we will be prepared both to communicate with members about the new recertification requirements, and to help any members caught in the administration confusion to regain the benefits they may lose.
During COVID-19, and in more familiar times, managed care organizations need flexible partners, willing to listen and able to implement member communications in a timely and effective manner. We’re proud of the work we are doing in this challenging period, and we look forward to serving even more dually enrolled Medicare Advantage members in the years to come.
As always, we are excited to talk about our Medicaid recertification program or Social Determinants of Health in general. If you want to chat, please drop us a note today at Sales@BeneLynk.com
About the Author
Sean Libby has been an advocate for seniors, people with disabilities, veterans, and individuals with low income for over 17 years. At BeneLynk, we are committed to helping managed care plans to deliver superior Social Determinant of Health solutions to their members. We are always looking to learn more and would like to hear your ideas on how best to assist members in need. Drop us a note at Sales@BeneLynk.com.
#DualEligible #MedicareAdvantage #Medicaid #MOE #PHE #Medicare #DualEnrolled