Post PHE Recertification

With the end of the Public Health Emergency (PHE) and continuous Medicaid enrollment, health plans could face an estimated 13% disenrollment of their Medicaid members*. For example, if a plan with 200,000 Medicaid members loses 13% of their membership (26,000 members), assuming $200 average pmpm, that could result in an annual revenue loss of more than $60 million.

This could actually be a much higher number given that Medicaid enrollment grew 20.5% between February 2020 and November 2021. Even with auto recertification strategies, as much as 30% of health plan membership may be targeted for active recertification. To mitigate the loss of millions of Medicaid members and the revenue associated with them, health plans need to strategize the unwinding of PHE now.

 

We do this through:

1) Outreach - Our compassionate associates outreach to the targeted lists of members falling off Medicaid. We can also utilize text messaging campaigns to reach those we are unable to reach with a live agent.

2) Assessment - We will assess/verify the individual’s assets and incomes via our live eligibility process to determine which programs the member may be eligible for using our workflow platform that includes state specific income and asset criteria.

3) Application/Submission - As part of our service, Centauri initiates the application with the local county agency and educates members regarding follow up tasks/next steps to ensure the best possible outcome.

Key Differentiators

  • 35+ years' Medicaid eligibility and enrollment experience
  • Strong agency relationships at every level
  • State-by-state rules engine
  • Recorded call for consent confirmations and Electronic consents.
  • Online submission in majority of states (linking of accounts)
  • Summary and member level reporting
  • HITRUST Certified
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