Proposed initiatives could prevent churn among Medicaid’s youngest members
“Churn” continues to make headlines, because for some, it may be devastating.
In healthcare, churn refers to patterns of intermittent coverage, when program members are enrolled, dis-enrolled and re-enrolled, either over their lifetimes or for the duration of a specific time period. Researchers are learning more every day about the causes and impacts of this phenomenon, particularly among Medicaid members.
This complex problem has no clear solution, though some innovative policies are being proposed. For example, in some states, program leaders are moving forward with plans to stop the churn among children. One increasingly popular push aims to keep kids enrolled in Medicaid through age six automatically.
How Churn Happens, and Whom It Hurts
Often, individuals caught in the churn qualify for Medicaid coverage throughout the period in which they are unenrolled, but their coverage is disrupted for bureaucratic reasons. These may include narrow re-enrollment windows, complex document requirements or technical challenges. In other cases, members lose coverage because they temporarily become ineligible due to short-term changes – such as income or custody arrangements – only to become eligible again a few months later.
Children often suffer the most in these coverage fluctuations. They have no say in the process at all, yet the immediate and long-term impact of churn on their health could be steep.
The U.S. Census Bureau reported in 2021 roughly 35.9 percent of kids in the U.S. received health insurance through Medicaid. Many of those kids benefit from protections enacted when the federal government declared the COVID-19 pandemic a public health emergency (PHE). Among those protections was guaranteed continuous coverage through Medicaid—an instant, yet temporary, churn-preventer.
The unwinding of the PHE is set for May 2023. When that happens, researchers estimate 6.7 million children will lose their Medicaid coverage. As it stands, those kids will likely experience some period during which they’re uninsured.
Even for those who re-enroll eventually, the uninsured period can be harmful to long-term health.
Consider the effect of churn on a child with asthma, a condition that impacts one of every 12 kids. The disorder’s commonality doesn’t make it less severe. In addition to being at greater risk for respiratory illness, asthma itself can be deadly: 300 children die from asthma attacks each year in the U.S.
Respiratory physicians have great success treating asthma with preventative medications. For many families, programs like Medicaid, among other solutions, could make the difference between affording a medication and being forced to go without.
Stop the Churn, Keep Kids Safe
Whether initiatives like automatic enrollment are adopted or not, we have solutions to help support agencies in their quest to minimize churn among members. FEI’s Blue Compass case management solution for LTSS makes it easier for agencies to keep current beneficiaries eligible for coverage enrolled in Medicaid with process automation. Our solution streamlines initial client screening, eligibility determination and enrollment functions.
Our Blue Compass solution is configurable to meet the needs and rules established by individual states and agencies. No matter the criteria, eligibility determinations for clients can occur right from the solution. Once eligibility is determined and plans of care are created, Blue Compass workflows automates enrollment and re-enrollment processes, based on agency rules. Configurable timelines trigger those automated processes appropriately, saving significant time.
Streamlining processes cuts down on churn due to long wait times or error. While technology is only one part of the solution, every step we take to keep vulnerable members of your communities covered matters.
