Why This Newsletter
Medicaid is a state-federal insurance program for the working poor and very poor families and individuals. Medicaid is of interest to companies because it is now the largest health insurance plan in the USA based on the number of enrollees, which currently stands at 94 million.
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How did this happen? Back in March 2020 COVID pandemic federal legislation required all (50+) Medicaid programs across the USA to halt disenrollments and to implement continuous enrollment provisions. Disenrollment is the temporary loss of Medicaid coverage because of a enrollee’s short-term changes in income or other circumstances which make them temporarily ineligible for Medicaid coverage. On March 31, 2023 federal legislation went into effect to put an end to continuous enrollment into Medicaid and to restart the process of disenrollments.
Primarily due to the March 2020- March 2023 continuous enrollment period, as of March 2023 there was more than 94 million people enrolled in Medicaid and CHIP. This makes Medicaid the largest health insurance plan in the USA.
From the reactivation of disenrollments starting in March 2023, between March 31, 2023- October 11, 2023, over 8.69 million Medicaid beneficiaries were disenrolled or lost their Medicaid coverage and 15.42 million had their Medicaid coverage renewed.
There is wide variation in disenrollment rates across the reporting USA states, ranging from 66% in Texas to 11% in Illinois. Variation in USA state disenrollment rates can be due to some states targeting early renewals, differences in renewal policies and system capacity. Some states such as Texas and South Carolina are targeting people early they think are no longer eligible or who did not respond to renewal requests during the pandemic. Other states have adopted policies that promote continued Medicaid coverage among those who remain eligible. Some states have automated eligibility systems that can more easily and accurately process renewals while other states have adopted fewer of these policies and have more manually driven systems.
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About Rowinski Group
Founded in 2004, Rowinski Group LLC is a reimbursement and healthcare payer data analytics consultancy for medical device, digital health and diagnostics companies who are developing and selling their medical technology in the USA. Rowinski Group has its USA offices in the Silicon Valley – San Francisco Bay area and the cities of Chicago, Minneapolis, and Raleigh.
Rowinski Group has two core service offerings; securing codes and reimbursement on behalf of companies and applying healthcare payer data analytics to help companies solve business issues such as responding to questions from the FDA and Medicare, sales forecasting, Key Opinion Leader (KOL) identification etc.
Through these service offerings Rowinski Group help U.S. and international companies build their U.S. market share for the medical technology they are developing and selling. For more information visit https://reimbursement.consulting or contact Daniel Zimmerman d.zimmerman@reimbursement.consulting.
