Continuity of Medicaid Coverage Improves Outcomes for Beneficiaries and States
Numerous studies illustrate the benefits of continuous enrollment in Medicaid. Continuous coverage improves beneficiaries’ health, lowers spending per individual, and eases administrative burden for states. In contrast, beneficiaries with disruptions in coverage are more likely to have unmet medical needs, unfulfilled prescriptions, and medical debt.
Medicaid eligibility fluctuates for beneficiaries whose income changes throughout the year or who experience coverage gaps due to delays in re-determination. This movement in and out of Medicaid, commonly referred to as churn, can be disruptive for individuals and their healthcare while increasing costs for states and the federal government.
As Medicaid reform efforts continue at the state and federal levels, it is important for policymakers to consider policies that support continuity of coverage in the interest of improving individuals’ health outcomes while reducing costs. Medicaid managed care organizations are ready partners to work with states and other stakeholders to identify strategies that can prevent gaps in care while supporting states’ goals for their Medicaid programs.
Related Public Policy Research
Addressing Prenatal and Postpartum Coverage Gaps in Medicaid
Medicaid is a critical source of insurance coverage for pregnant women. However, there are still gaps in coverage, due to delays in when pregnant women access Medicaid managed care benefits and how long after delivery they retain coverage.
Medicaid Managed Care Delivers Value and Efficiency to States
Findings from the literature demonstrate that, compared to FFS, Medicaid managed care improves quality and individuals’ experience, enhances access to care, and helps states manage costs.
Healthy Indiana Plan 2.0: Enhanced Consumer Engagement and Decision-Making Are Driving Better Health
Early results from HIP 2.0 demonstrate successful engagement of Medicaid members in their healthcare, such as members having lower inpatient and ER use once in HIP compared to FFS Medicaid.