As states emerge out of the pandemic, “business as usual” will look different for many Medicaid programs.
The COVID-19 pandemic continues to cast concerns on Medicaid enrollment, delivery, and costs. This has ramped up the need for state leaders to create new Medicaid strategies that reshape their programs, address new challenges, and leverage lessons learned.
The demand for behavioral health services has increased at record levels, and job loss and extended isolation will continue to have a long-term impact on Medicaid populations. As states emerge out of the pandemic, “business as usual” will look different for many Medicaid programs.
Everything from enrollment and eligibility redeterminations to in-person care delivery, care coordination, and home and community-based services is on the table.
Why state leaders are rethinking Medicaid
Although the Biden administration continues to extend the public health emergency, the Centers for Medicare & Medicaid Services (CMS) has issued guidance to states on planning for resumption of “normal” state operations, and the administration is expected to offer additional guidance.
State leaders should take this opportunity to proactively plan for the transition. Re-examining existing business practices and considering making permanent the solutions tested during the pandemic may offer improvements in quality, costs, and access to care.
Creating resilient and responsive programs for the long term
Improvements in effectively managing social determinants of health, population health, and community integration have never been more necessary. States need a thoughtful and cohesive strategy to efficiently meet the needs of their populations.
The first step is for states to evaluate the benefit of maintaining certain temporary regulations (e.g., telehealth) and coverage options as part of a broader post-COVID-19 strategy. Missing the window to engage in this thoughtful analysis, will be a missed opportunity to make permanent flexibilities and innovations that were critical tools during the pandemic, such as telehealth and the broader use of mid-level practitioners to provide care.
A long-term post-COVID-19 strategy and roadmap is essential to effectively manage and understand the impact of the pandemic on existing programs, plan for a brighter future, and successfully implement and communicate new policies and procedures with key stakeholders.
Questions for state leaders to address by key area
Eligibility & Enrollment
Provider Rates & Taxes
Delivery System and Social Determinants of Health (SDoH)
Long-Term Services and Supports (LTSS)
Ultimately, applying the most recent technology advancements and lessons learned during the pandemic will ensure a Medicaid service delivery model that is faster with a more personalized and accessible consumer experience.
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