Earlier this year, I explored the potential impact of the end of the current Public Health Emergency (PHE). The U.S. federal government has been operating under a PHE for COVID-19 for more than 30 consecutive months since it was initially announced in January 2020.
On July 15, 2022, this PHE was renewed for a tenth time. Following this latest extension, the Centers for Medicare & Medicaid Services (CMS) has released a roadmap for the end of the COVID-19 PHE. In a related blog, they reiterate the commitment to provide a 60-day notice prior to the end of the PHE, but urge states and healthcare providers to prepare for the end “as soon as possible.”
With these upcoming changes in mind, I wanted to review key areas for providers to consider as they prepare for the end of the PHE.
Enrollments continue to increase, putting state budgets at risk
From the start of the PHE in February 2020 through April 2022, Medicaid/Children’s Health Insurance Plan (CHIP) enrollment has increased by more than 17M people and this is affecting every state. Nearly half of all states have experienced an increase of more than 25% during this time period, with some experiencing increases of more than 40%.
Given an average Medicaid cost to states of more than $8.4K per capita, that translates to an increase of billions of dollars. Once the PHE expires, states will have 12 months to redetermine eligibility for continued enrollment in the program, or risk bearing 100% of the associated cost.
Preparing for the end of the PHE
To avoid unnecessary expenditures and ensure that citizens are receiving access to the correct services, states will have to conduct a holistic review of their Medicaid rolls to confirm eligibility. In CMS’s guidance for states to prepare for the end of the PHE, they recommend creating an automated process to handle this unprecedented review.
With the right partner, agencies can perform redeterminations of their existing registration rolls, and prepare for future services requests. The right solution can allow citizens to easily apply for benefits, triggering the automatic, real-time pull of income and employment information so that the agency can verify eligibility.
Experian is a trusted government partner that is ready to assist states with preparing and automating the process for redetermination of benefits. To learn more about how Experian can assist with citizen benefit redetermination and registration efforts, visit us or request a call.