If you haven’t heard, the Centers for Medicare & Medicaid Services (CMS) recently announced a Medicaid and CHIP (Children’s Health Insurance Program) “Unwinding” program slated to begin on October 13th, 2022. COVID-19-related Medicaid legislation and enrollment flexibilities adopted by states during the pandemic have increased both Medicaid and CHIP enrollment to nearly 87 million individuals nationwide.

With more people than ever before receiving critical health services from these programs, this “Unwinding” announcement is now a massive social impact issue for millions of vulnerable Americans. As of the 13th, the CMS is unraveling these enrollment flexibilities and reverting to the standard eligibility validation processes that were used before the pandemic.

How Many Americans Will Be Affected?

Estimates suggest that as many as 15 million people will be victims of ineligibility for the health programs they’ve been relying on for medical care since 2020. It’s further estimated that 6.8 million recipients who will remain eligible could lose their coverage due to administrative issues such as incorrect patient data (i.e., name changes, incorrect address, or data not syncing).

How Should Healthcare Providers Communicate with Their Patients?

In the CMS Medicaid Unwinding Kit, the CMS recommends implementing a direct mail campaign to educate current Medicaid and CHIP enrollees about the program. Another alternative is voice calls, but those often go unanswered (and this assumes that Providers and States both have current enrollee phone numbers in the first place). If Providers and Health and Human Services departments can’t reach members to reenroll them, they will lose coverage.

If you’re a healthcare provider or you work for a State or Local Health and Human Services department, the time to step up and leverage technology to solve this massive problem is now. Learn how by reading our latest blogs on the mandate:

[su_row][su_column size=”1/2″ center=”no” class=””][su_button url=”https://www.acqueon.com/resources/ebooks/conversational-engagement/” background=”#e96429″ size=”3″ radius=”0″ center=”yes”]Impact for Healthcare Providers [/su_button][/su_column] [su_column size=”1/2″ center=”no” class=””][su_button url=”https://www.acqueon.com/blog/states-beware-for-cms-unwinding-what-you-really-need-to-do-to-reach-87-million-people/” background=”#e96429″ size=”3″ radius=”0″ center=”yes”]Impact for State Departments[/su_button][/su_column][/su_row]

What You Can Do Immediately

  • Start Bulk Eligibility: Through your financial clearance provider, run this check at least monthly. Two times per month is best. This will give you a continuous flow of rejections & denials that can be put into a queue for proactive outreach before that individual:
    • Scheduling an appointment
    • Coming in for medical care or worse
    • Having the claim denied after treatment
  • Get Proactive: Do not wait around to handle Medicaid or CHIP enrollee outreach. Do not depend on the government to contact your patients for you. Your margins, your practice & your ability to effectively provide care are all at stake.
  • Contact Your Patients: If you don’t have one in place, you’ll need to develop a program or process for proactively contacting your patients who are currently covered by Medicaid or CHIP.
  • Provide Patients with Re-Enrollment Information: Set your patients up for success by giving them the information they need to re-enroll and re-certify their eligibility. Don’t wait around to contact them—there’s widespread uncertainty about how these large-scale communication efforts will unfold.

How Acqueon Can Help Providers & State Departments That Will Soon Be Impacted by the CMS Unwinding Mandate

At Acqueon, our mission is to transform the future of conversational engagement. The foundation needed to achieve this goal is proactive engagement—the same foundation Providers and State Departments need to tackle the CMS mandate.

If this volume of outreach seems overwhelming, that’s understandable. Without the right cloud-based, scalable technology and a team of experts available to guide the process and strategy, it is. There’s no sugar-coating that. But you can get ahead of this looming catastrophe by working with a partner like Acqueon.

Our Conversational Engagement Platform, Acqueon Engagement Cloud, is built to tackle outreach and omnichannel campaigns of this magnitude. It will enable you to push personalized communication and campaigns at scale, using automation, to the channel of your choice—email, voice calls, or SMS/text. Just think about how much administrative work and staffing you can cut down on by leveraging this pre-built technology.

Acqueon Engagement features capabilities for voice, callback options, IVR campaigns, e-mail & SMS/text outreach. Not only is our platform equipped to tackle CMS Unwinding, but we’ve also built infrastructure to support this initiative:

  • It can be tailored for any state
  • It can be built & operational in under 60 days
  • It will work with your current contact center solution
  • There’s no hardware required
  • There’s no additional investment in people required 

Helpful Tips for Using Our Conversational Engagement Platform:

    1. Providers and States should use the pre-built outbound campaign (with our Campaign Manager) to proactively push critical information to affected individuals. Intelligent campaign management technology is vital for finding people on the communication channel where and when they’re most likely to interact—be it via phone call, email, or text/SMS.
    2. Next, you’ll want to layer in Acqueon’s pre-built campaigns to whatever contact center, CRM, or EHR solution you’re already using. Acqueon is a plug-and-play, seamless integration and we’ve designed this offering specifically to help Providers and States tackle the CMS Unwinding program requirements.
    3. Next, you’ll want to layer in Acqueon’s pre-built campaigns to whatever contact center, CRM, or EHR solution you’re already using. Acqueon is a plug-and-play, seamless integration and we’ve designed this offering specifically to help Providers and States tackle the CMS Unwinding program requirements.

Who Can Use the CMS Unwinding Omnichannel Campaign Management Solution?

Everyone from Providers to the State Department of Health and Human Services. Our pre-built campaigns use our ready-made scripts, and your patient data to push communications through our advanced Campaign Manager.

Discover the Solution Built to Tackle the CMS Continuous Enrollment Unwinding

The way to get ahead of this and mitigate the risk of yet another public health emergency is to act quickly. After all, helping patients and citizens live healthier lives is the goal, right? Waiting too long to take action on this mandate leaves the most vulnerable Americans overlooked, underserved, and without access to the healthcare they need to live their best, healthiest lives.

If you’re a Provider or work for a State Health and Human Services Department and you need help with what comes next, contact Acqueon. We’ll start the journey to tackle the CMS Unwinding Program proactively—together.

[su_button url=”https://www.acqueon.com/cms-medicaid-unwinding-program-solution/” background=”#e96429″ size=”3″ radius=”0″ center=”yes”]Get Help with CMS Unwinding Enrollee Outreach[/su_button]