CHRT study shows effectiveness of MDHHS outreach methods to Medicaid members


Patrick Jones


The Center for Health and Research Transformation (CHRT) at the University of Michigan deemed Michigan Department of Health and Human Services (MDHHS) communications with Medicaid members robust and helpful to their continuing coverage. 

CHRT recently released a study discussing how well MDHHS communication methods promulgated the implementation of new work requirements to the Health Michigan Plan (HMP) in early 2020. The study gathered 11 focus groups of health navigators from around the country to get a better understanding of how these communication methods impacted and informed communities around the state. 


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In 2018, the Michigan Legislature passed Senate Bill 897, which added work requirements to recipients of HMP. The bill required members to report at least 80 hours of work per month, unless they were exempt due to disability or other commodities. In Jan. 2020, HMP implemented this work requirement policy and started sending communications of this change to their members. 

The 11 focus groups of Michigan navigators said they felt prepared to assist enrollees navigate these new requirements and the communication methods of MDHHS was an improvement compared to traditional Medicaid communications. More than two-thirds of the 44 respondents felt the state did extremely or very well in communicating information about the work requirements. Twelve more respondents (30%) felt the state communicated moderately well.

“The department took a number of steps to make their communications more easily digestible or human-centered to draw more attention to their communications to Medicaid beneficiaries,” said Patrick Kelly, lead author of the study.

Kelly said MDHHS used colored envelopes to bring attention to the letter in the mail and used more digestible fonts and spacing to improve readability and  relay the information in a streamlined and direct way. Navigators said beneficiaries were much more likely to read and respond to these notifications. 

Kelly said MDHHS also used administrative data to automatically exempt or qualify beneficiaries to reduce the amounts of members who needed to be notified and take action. Of the 700,000 beneficiaries affected, only 200,000 received letters about this new policy change. The other 500,000 were either automatically exempt or qualified to meet the benchmark, therefore eliminating that administrative burden. 

“People were able to be administratively removed from that reporting process,” Kelly said. “I think that was really helpful.”

Though navigators said these new communication interventions worked better than previous methods, 80,000 Medicaid beneficiaries still were at risk of losing coverage as of March 2020, when the COVID-19 pandemic hit. 

Kelly recommended that MDHHS continue to adjust these methods of communication through trial and error to see how people will best respond to communications. For example, he said the department can continue to change the amount of letters sent, different language options, and improve telephone communications.