State Medicaid Agencies Face Staffing Shortages as Redeterminations Resume

  • Mar 17, 2023

    Many Medicaid agencies’ “frontline eligibility” divisions and call centers are understaffed, according to the Kaiser Family Foundation’s (KFF) just-released annual survey of state Medicaid officials, which was fielded in January. That could complicate income checks and other parts of the eligibility redetermination process, which will resume on April 1 after a yearslong pause due to the COVID-19 pandemic.  

    State Medicaid programs are ultimately responsible for determining whether a Medicaid enrollee is in fact eligible for enrollment in the program, but Medicaid managed care organizations (MCOs) also have a hand in managing disenrollments — and have strong incentives to keep as many members enrolled as possible. Indeed, the survey found that 41 states are relying on Medicaid MCOs to “conduct outreach and assist members” as they navigate the disenrollment process; 33 states provided MCOs with “advance lists of members up for renewal,” and 26 states have sent out “advance lists of members who may be disenrolled because they have not responded to requests for information.”  

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  • Peter Johnson

    Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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