Tag: public health emergency

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. Learn more

Since January 27, 2020, the federal government has been operating under a Public Health Emergency (PHE) related to the COVID-19 pandemic. On January 14, 2022, this PHE was renewed for an eighth time. While we are currently in the midst of the omicron surge, some suggest that we may be nearing the beginning of the end of the pandemic — and thus the inevitable expiration of the PHE. Impacts of the PHE While the PHE remains in effect, states must maintain current Medicaid enrollees, regardless of changes to their eligibility status. A recent report showed Medicaid enrollment increased 16.8% from February 2020 to June 2021. This is counter to the previous trend, where enrollment declined from 2017 to 2019. Furthermore, the average per capita Medicaid cost to states is estimated at $5K–$10K (states share about one-third of the cost of Medicaid). The combination of the per capita expense and the increased number of enrollees during the pandemic translates to a significant impact on state budgets. Once the federal order expires, states will have 12 months to redetermine eligibility for continued enrollment in the program, or risk bearing 100% of the associated cost. Processing redetermination in a timely manner is critical for states to avoid unnecessary expenditures and to ensure that citizens are receiving access to the correct services. It’s imperative that states start planning for redetermination of benefits for continued Medicaid coverage as soon as possible to be prepared to take action at the inevitable conclusion of the PHE. Preparing for redeterminations At the end of the PHE, states will need a system to easily and confidently review their current Medicaid rolls to confirm eligibility. Implementing this system will likely involve working with a trusted partner who can provide tools and advantages such as: Portfolio analysis Real-time analysis Verification of income and employment Compliance adherence Affordability With the correct systems in place, states can act quickly once the PHE ends, saving unnecessary expenditures and providing better services to citizens in need. If your state agency would like to learn more about how Experian can assist with citizen benefit redetermination efforts, visit us or request a call. Learn more