Redeterminations and Disenrollments

Ensuring vulnerable, at-risk populations are enrolled in healthcare coverage

As states continue redeterminations and disenrollments, Kaiser Family Foundation estimates that by May of 2024, close to 17 million Americans are at risk of losing Medicaid coverage or experiencing a gap in coverage due to challenges with completing the renewal process, even if they remain eligible for coverage¹.

Healthcare Dynamics International (HCDI) works with well-known managed care organizations (MCOs) to ensure vulnerable, at-risk populations are enrolled in healthcare coverage. Our talented, diverse staff of over 150 full-time professionals from 20 different countries provide culturally sensitive member outreach and educational resources to improve health outcomes for all, especially those most vulnerable.

HCDI has a proven track record of successfully engaging the most difficult-to-reach members to assist them with maintaining, or in some instances, regaining their coverage. We have worked with Medicaid MCOs to conduct over 60,000 redetermination calls to help their enrollees keep or regain healthcare coverage. HCDI prioritizes relationships over transactions. Not only do we work with members to ensure they are covered, we connect them to social determinants of health support resources, and assist them with the services they need to get and remain healthy.

HCDI’s Redetermination Outreach Method

Conducting Outreach
Conducting outreach through phone calls and emails to members at risk of losing coverage or who have lost coverage
Collecting and Analyzing Data
Collecting and analyzing data, including data about social determinants of health and social support service needs
Reengaging Members
Reengaging members, if necessary, especially if we are unable to connect with them through the first contact attempt
Providing Health Plan Reenrollment Information
Providing health plan reenrollment information or facilitating a warm handoff to the state health insurance navigator

Health plan leaders have a keen awareness of the implications of enrollees losing their coverage, including member attrition and revenue loss. They recognize that gaps in coverage could result in reduced access to health care which can lead to enrollees becoming sicker over time. Helping enrollees maintain coverage requires an immediate comprehensive approach and aggressive redetermination efforts.

To learn more about HCDI and how we can support your redetermination efforts, contact us directly at info@HCDI.com.

Source: www.kff.org

Redeterminations and Disenrollments

HCDI’s Redetermination Outreach Method

HCDI is a Learning Organization!