Coloradoans are dropping Medicaid at 4x the average rate. Why?
Medicaid expansion was great... For a year. But then life goes on and people forget that there are requirements to stay covered.
Coloradoans are dropping Medicaid at 4x the average rate. Why?
There is work to be done to keep coverage.
Public coverage is not like the private sector where insurance just renews each year as you pay premiums. You have to re-qualify over and over and over again.
But who do the Medicaid members turn to? The state? LOL. The state won’t help you stay covered.
This is why Colorado is seeing an 8% Medicaid churn rate when the national average is only 2.3% (which is low based on our data).
What good is expansion without the distribution of coverage representation? Without the resources to help members get through the process? Without the incentives for anyone to keep patients covered?
But wait a second, FQHCs have a ton of incentive to keep patients covered. They receive a PPS rate with each covered visit. In fact, the annual value of a covered Medicaid patient often exceeds $500. Why aren’t FQHCs able to manage member coverage? Because EHRs and EMRs are a mile wide and an inch deep. And with most of their products focusing on patient care coordination, Eligibility and Enrollment Departments are left to rely on fragmented spreadsheets and data-less processes.
PointCare will become the Member Coverage Management platform. As the reality of patients dropping public coverage starts to hit financial bottom lines, the answer is to (counter-intuitively) invest in the Eligibility and Enrollment Team and give them the tools to keep patients covered. Software like PointCare automates this process, which ultimately results in happier members (now that they have coverage representation) and more covered visits. It also aligns with many FQHCs’ missions to educate and provide for their communities.
To learn more about PointCare, maybe it’s time you Evaluate Your Self-Pay Enrollment Cycle.
Note: Our Customer Success Advisors have implemented PointCare in over 600 health system sites nationwide who have decided to simplify their self-pay enrollment cycle. We are now providing free enrollment cycle assessments for those who qualify. Learn more at www.pointcare.com.