Working collaboratively to ensure members keep their coverage

Due to the COVID-19 Public Health Emergency, Medicaid beneficiaries were not required to re-prove eligibility for three years. However, this exemption ended in 2023. Across the nation, there were massive enrollment losses due to various re-enrollment challenges, including complex requirements, a lack of public awareness, and challenges with contacting enrollees after three years that saw displacement caused, in no small part, by COVID’s impact on the economy.

In California, the Department of Health Care Services was determined to support retention efforts through a variety of measures, including flexibilities offered by the Biden Administration.

Critical to CenCal Health’s retention efforts were strong partnerships with providers, community-based organizations, and – for the first time – the Departments of Social Services in Santa Barbara County and San Luis Obispo County. Working cooperatively through semi-weekly collaboratives with these agencies, CenCal Health was able to secure data that allowed for a robust retention effort. The results in both counties met or exceeded the average retention rate in the state in the first seven months through December 2023.

CenCal Health also customized retention text messages and pre-recorded voice calls for what worked best for each county’s DSS needs. CenCal Health members were contacted with clear and timely instructions on actions needed to respond to county efforts to redetermine eligibility and where they could seek assistance. For many members, the communications from CenCal helped prevent eligible members from disenrollment due to procedural barriers, such as wrong addresses.

The results prove once again the value of collaboration.