‘A disaster waiting to happen’: Do staff shortages threaten MediCal plans for renewing recipients?

In Colorado, the state is taking a high-tech approach to connecting with its enrollees, contracting with El Dorado Hills, CA. based fintech company Intellaegis to use its software database and case management system to find people whose addresses have changed.

Intellaegis gets its information from a variety of sources — LexisNexis, Equifax, TransUnion, Thomson Reuters and the like, said John Lewis, the company’s chief executive officer.. Typically, customers come from the ranks of financial institutions, insurance companies and even law enforcement, looking to track down people that have no valid forwarding addresses with the U.S. Postal Service, Lewis said. The company’s software also ensures that users comply with all data security and privacy regulations when making contacts. The leaders of Colorado’s Medicaid program opted for Intellaegis’ masterQueue software program because it eliminated the need for spreadsheets and a lot of manual labor. They simply uploaded information on returned mail into masterQueue and received new addresses and phone numbers, streamlining the effort it took to find and contact enrollees.

“It’s not easy to find people who are not necessarily wanting to be found, or who don’t have as much data out there as other people who are a little more stable,” Lewis said. “We know that because our software is used by not just prime lenders but also by subprime and deep-subprime, and some of the characteristics of a person who’s struggling financially a little bit on the lending side can be like the people who are struggling with health insurance. They don’t have a job that provides them with great health care, so they’re on some form of government-assisted health care.” A recent case study showed that with masterQueue, Colorado’s rate of reaching enrollees with whom it had lost contact rose to 17.5% from 5.9% in just two months, Lewis said, and this will help states renew cases at a higher rate without having to hire additional staff.

IN AN UPDATE SINCE THIS ARTICLE WAS PUBLISHED IN APRIL, Colorado reached 28% of their lost Medicaid enrollees in July, and some of their users are reaching closer to 60% in August after some minor changes to the process. Contacting the enrollee allows the State to reduce Procedural Disenrollment rates by talking to people to make more accurate Medicaid Eligibility Determinations before continuing their coverage, or before disenrolling the person from Medicaid. Procedural disenrollment has become a large issue in many States, and the Department of Health and Human Services and the Center for Medicaid Services sent letters to all State Medicaid Directors on August 9^th  to remind them of the importance of reducing procedural disenrollment where possible.