During 2020 we saw a record high of 8,796 changes to health programs across the country, including new programs, eligibility criteria, and updated applications. It is likely that many of these changes were driven by COVID-19 and the shifting healthcare landscape. Although Q4’s 1,394 changes were the fewest of any quarter, more programs overall had some kind of change when compared to the previous quarter.
As COVID-19 stretches into the fall, we continue to see the effects of the pandemic on public and private benefit programs. With more changes than ever, including changes to eligibility, the introduction of new programs, and Medicaid expansions, an increasing number of patients are eligible for coverage.
Three states are expanding Medicaid in the next year, affecting over half a million Americans. This change will allow for more people to meet Medicaid criteria, particularly low income childless adults. With more patients than ever before, qualifying patients quickly and accurately is key to converting self-pay to covered visits.
Insurance programs and benefits are constantly shifting eligibility requirements, application processes, web site navigation, and more. In Q1 of 2020, we saw 2,366 changes to programs, a record high compared to the last several years of data. This means that for a frontline team member screening patients for coverage, it is next to impossible to keep up with the latest requirements. Misinformation is harmful to the patient and the healthcare facility, leading to denials and preventing reimbursement for services rendered.
In the time of COVID-19 this is more true than ever, with changes being made to presumptive eligibility and other program features aimed at addressing the growing healthcare and unemployment crisis. Here are some of the most important changes we tracked in the second quarter of 2020: