Friday, February 7, 2014

Whitepaper: Minimizing Care Gaps for Individuals Churning between the Marketplace and Medicaid: Key State Considerations

Today's excerpt has been provided by Veronica Guerra and Shannon McMahon from Center for Health Care Strategies
Of the estimated 96 million Americans eligible to receive Medicaid or Marketplace subsidies during any given year, up to 29 million are likely to “churn” between all coverage options, and seven million are likely to experience coverage shifts between Medicaid and marketplace policies annually.1 Based on past experience, adults who change health insurance coverage are less likely to have a usual source of care and report delaying care during coverage transitions.2 Those who churn between Medicaid and the newly established marketplace will, at a minimum, have different benefits and out-of-pocket expenses (e.g., premiums and cost-sharing). Further changes in plans, provider networks, and eligibility status could result in a lack of care coordination, unmet needs, and/or an exacerbation of chronic conditions.3 In addition, high rates of churn across the new array of Medicaid-marketplace coverage options will put an increased administrative burden on states and contracting health plans.

Given the likely churn between Medicaid and the marketplace, states can take steps to ensure coverage and care coordination so health status does not deteriorate during these transitions. A handful of states have begun to estimate the potential magnitude of churn on their current and newly eligible populations, and are exploring options to mitigate churn. This brief, made possible through the Robert Wood Johnson Foundation, outlines concrete strategies for states to mitigate the impact of coverage transitions.

You can view the full article here. CHCS will be joining us May 19-21 in Baltimore, MD for IIR's Medicaid Managed Care Congress. To learn more, view our agenda. Want to hear more from CHCS? Register with code XP1926BLOG. 

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