CareOregon connecting members to resources they will need during Medicaid redetermination process
CareOregon staff are focused on ensuring customers are connected to resources they will need during the Medicaid eligibility redetermination process as the end of the public health emergency’s (PHE) continuous coverage requirement approaches.
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The federal government provided continuous coverage for Medicaid recipients during the COVID-19 pandemic through the PHE, regardless of whether or not their eligibility changed. The PHE will end on May 11th, and its continuous coverage provision will end on March 31st.
The Oregon Health Authority (OHA) will begin eligibility redeterminations for Oregon Health Plan (OHP, the state’s Medicaid system) members in April, and hundreds of thousands will be at risk of losing coverage. OHA will begin contacting members in April, and they will have 90 days to submit the paperwork necessary to renew. Disenrollments will begin on June 30th.
Health plans are working to update customer information, contact them, and guide them to other coverage options if they are determined to be ineligible for Medicaid. CareOregon COO Amy Dowd discussed the process with State of Reform.
“One of the most important things we have to keep in mind is that the state is leading the process,” Dowd said. “And we are doing everything we can to augment that, stay aligned with them, and expand on their work. Up to this point, our primary objective has been updating addresses for current OHP members. We’re performing phone call outreach to members to check on their addresses and make them aware of the redetermination process.”
When the state begins eligibility redeterminations for all 1.5 million OHP members, officials have acknowledged that a disproportionate number of them have already experienced health inequities—including higher rates of mortality during the pandemic—and are at a higher risk of experiencing lasting harms from COVID-19. It will be important for health plans to have the ability to communicate with members from different cultural groups.
“We’re thinking about limited English proficiency, and [offering] interpreter services,” Dowd said.
CareOregon has had good success rates in reaching customers since beginning the outreach process in January, Dowd said.
“Our two (coordinated care organizations) are at around a 25% rate in reaching people,” she said. “We want to reach everyone, and are working diligently on those efforts. We’re focused on providing as many options as possible. We’re making sure they know how to get assistance with assessing their options with a navigator, a certified agent of the state, or other options. That’s the most important thing, is having a list of resources, of community-benefit organizations available for members.”
CareOregon has seen an uptick in customer calls at its contact center with the end of the PHE on the horizon, Dowd said.
“They’re starting to hear about it, so I think the interest and awareness is starting to pick up now,” she said. “It’s about using all our channels for outreach and awareness. It is so important to our members and the state to support OHA with this process.”
The Joint Task Force on the Bridge Health Care Program is also working to design a new insurance program to cover low-income residents who do not qualify for the OHP. The Bridge Health Plan would be offered to residents who earn between 138% and 200% of the federal poverty level.
CareOregon recommends that residents do three things to make the redeterminations process smoother:
- Update their address with OHA by logging into their ONE account or by calling 800-699-9075.
- Respond to any mailed requests from OHA, and make sure to complete any steps outlined in the notice as soon as possible, as residents will have 90 days to respond.
- Reach out for help with paperwork.
If OHA determines that members no longer qualify for benefits, they will have 60 days before their OHP coverage ends in order to determine other coverage options.