As quickly as the COVID-19 pandemic ignited a need for innovative solutions to strengthen state and local healthcare delivery systems, the Public Health Emergency’s (PHE) declared end is rechallenging governments’ abilities to provide quick, secure, and reliable citizen support. To understand the challenges citizens and governments will face in the next 12 to 14 months, it’s important to consider the journey that brought nearly 100 million Americans to this moment.
Globally and in the United States, COVID-19 exposed gaps in healthcare systems. In response, the United States expanded access to Medicaid, a nationwide health insurance program for citizens with limited income and resources. The Kaiser Family Foundation (KFF) reported 12 million enrollments through July 2021, and by October 2022, Medicaid enrollment grew to 91.3 million.
As variants emerged and rates of new cases periodically surged, the U.S. government halted states’ abilities to disenroll beneficiaries who no longer met eligibility requirements. Although the continuous enrollment provision decreased the rate of uninsured citizens, the massive spike in enrollment dramatically increased Medicaid case-loads and spending. On December 29, 2022, the Consolidated Appropriations Act (CAA) 2023, was signed into law that, among other things, delinks the continuous coverage provision from the PHE effective March 31, 2023.
During “unwinding,” states are required to redetermine Medicaid eligibility for all members. States will have 12 months to initiate eligibility reviews and two additional months to complete all pending actions. Beginning April 1, 2023, states are able to terminate Medicaid enrollment for individuals no longer eligible. In response, millions of current Medicaid beneficiaries concerned about losing their coverage for medical services will demand efficient and effective services from states and their partners.
What to Know
- KFF forecasts between 5 million to 14 million people will lose Medicaid coverage during the unwinding period.
- Medicaid agencies overwhelmed by citizen support demands are at greater risks of erroneously disenrolling beneficiaries. To reduce this risk, it’s vital that state resources remain available to handle complex cases by outsourcing the burden of processing basic requests, like resetting passwords or updating contact information.
- In addition to ongoing and significant workforce challenges, Medicaid servicing centers are forecasted to experience higher employee turnover as the unwinding process goes on.
- Gaps in healthcare delivery may reemerge, creating uncertainty and increasing demand for citizen support; current enrollees deemed ineligible will require assistance identifying and contacting resources to obtain new coverage.
- States must make good faith efforts to maintain up to date contact information and utilize multiple communication channels before disenrolling members (e.g., returned mail).
- States face fines and penalties for missing administrative and reporting requirements.
- States should also account for efficient vendor partner operations integration with any ex parte determination process.
Provide Effective and Efficient Citizen Support
Providing responsive service and satisfying citizen support journeys in the most cost-effective manner requires a nimble provider who can accurately predict future contact volumes across multiple communication channels and quickly optimize staff accordingly. Senture, a Teleperformance company, focuses on supporting U.S. federal and state governments, brings the ability to quickly deploy well-trained staff, focused on accuracy and empathy, to manage high volumes of interactions in fast-paced environments.
Unprecedented economic conditions and pressures have impacted the ability of government agencies to maintain, recruit, and train staff. Senture can help states meet workforce challenges and the increased case-loads due to PHE unwinding operations. Senture has a demonstrable record of success overcoming workforce challenges and providing surge support. Leveraging a robust workforce management program powered by the latest technologies, such as robotic process automation (RPA), advanced interaction analytics, and AI, Senture provides customized and flexible staff augmentation strategies that align with and adapt to unique and constantly evolving conditions.
To further improve the citizen support journey, Senture offers digital solutions to mitigate disruptions, improve support efficiency, and empower self-service. Greater accuracy and efficiency can also be achieved by leveraging Senture’s experience in collaborating with government agencies to obtain information and update internal systems.
Senture is “all about the people,” which will be critical while millions seek assistance in the face of uncertainty. To meet the added emphases on accuracy and empathy during unwinding process interactions, Senture offers recruiting tools to find the best candidates, and innovations in training can improve the time required to hire to proficiency. Additionally, as a company focused on providing public sector support, Senture benefits from a culture in which its 4,000 employees take pride in serving their fellow citizens with compassion.
Senture delivers customized, citizen-centric support services at all levels of government across a diversity of public programs. During these challenging times, Senture, powered by Teleperformance, is a proven provider of effective and efficient citizen support in these areas:
- Inbound/outbound support
- Helpdesk/IT support
- Knowledge management
- Citizen support (calls, email/mail campaigns)
- Back-office support, including data entry, application processing, OCR, document management, and inbound/outbound mailroom