Integrated Enrollment Contact Management (Medicaid Unwind)

Overview

In response to the pandemic, Congress granted qualifying states additional federal Medicaid funding through the Families First Coronavirus Response Act (FFCRA) on the condition that Medicaid programs allow people to stay continuously enrolled through the end of the COVID-19 public health emergency (PHE). However, in December 2022, the Consolidated Appropriations Act (CAA) was signed into law, de-linking the additional funding and continuous enrollment provision from the PHE and ending continuous enrollment on March 31, 2023. The CAA will also gradually reduce the additional Medicaid funding granted through the FFCRA, ending it in December 2023. As a result of this “unwinding,” the Center for Medicare and Medicaid Services (CMS) is mandating states to return to pre-COVID Medicaid operations and re-determine Medicaid eligibility. It is estimated that nearly 18 million enrollees across the nation will lose their Medicaid coverage due to the unwinding process. Under the new CMS guidance, state agencies must make a good faith effort to inform individuals of their Medicaid status, which includes sending paper-based communication to members of programs such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP). State agencies must ensure compliance with these requirements, and should invest in solutions that will add value going forward to improve engagement and quality of enrollee data.

Key Features & Functionality

• Streamlined contact management by automating the entire contact management process, including initial outreach, returned response
  parsing, address updating, and final follow-up.
• Automated mail analysis leveraging AWS Textract text analysis capabilities to automatically extract address details from returned mail and save valuable time for case workers.
• Seamless integrations with existing NCOA systems, allowing for automatic address updates from USPS to drive efficiency and speed.
• Automatically updated human services systems like Medicaid, SNAP, and TANF via Appian’s low-code integrations when a new address is detected.
• Increased enrollee engagement by allowing individuals to manage their contact information, verify automatic updates, enroll in programs, and manage notifications via email, text, and online in a mobile-accessible portal.
• Extensive tracking and oversight capabilities to provide states with detailed records and contact histories, promoting accountability and facilitating effective communication between human service providers and enrollees.

Benefits & Business Impact

• SPEED - Get a solution deployed rapidly (with an MVP ready in your environment within 6 weeks)
• ADAPTABLE - to your organization's unique process, requirements, and ability to incorporate your organization's data sources and business rules, as well as any future shifting regulations and requirements
• SECURE - Our solution is compliant with relevant industry standards including StateRAMP and HIPAA – keeping PII and PHI safe and secure
• AUTOMATION - Our solution automates the mundane, allowing users to focus on their most important tasks – driving increased efficiency and ROI