This blog is one in a series NACHC is doing to report on the impact of Medicaid redetermination on patients and how Community Health Centers are stepping up to help patients. View others in the series.
As growing numbers of Americans worry about losing their Medicaid coverage, Community Health Centers are trying keep eligible patients connected. A case in point is in Kansas, where the Medicaid renewal process for all KanCare (Kansas Medicaid) enrollees started in May. Kansas will need to process renewals for approximately 290,000 Kansans. State data from the end of June shows that around 82,000 Kansans were up for redetermination and one-fourth, just over 29,000 people were approved for Medicaid coverage. Over 7,400 people were determined ineligible for Medicaid and nearly 46,000 have been disenrolled from KanCare for procedural reasons.
Given that such a large portion of Kansans being redetermined for Medicaid may be patients at health centers, we spoke with two health centers about how they keep patients connected to coverage.
GraceMed Health Clinic: The Power of Consistent Outreach and Relationship Building
GraceMed serves 52,977 patients across 16 clinics in four cities and towns, covering parts of northeastern and southcentral Kansas. Juven Nava, Director of Outreach & Eligibility (O&E) at GraceMed and his team of nine say the winning formula for ensuring patients and community members maintain coverage is through maintaining relationships.
GraceMed prepares for Medicaid redeterminations by prioritizing relationships, consistency, and intentionality. As second-time recipients of the Centers for Medicare & Medicaid Services Healthy Kids grant, GraceMed has been able to leverage their existing Healthy Kansas Kids outreach efforts to address the end of Medicaid continuous enrollment. GraceMed O&E staff used the grant to establish a comprehensive outreach schedule prior to Medicaid unwinding. The O&E team visits 29 counties in-person with a laptop, hotspot, and scanner in tow. They hold “lobby sits” in public spaces like libraries, schools, and state Women, Infants and Children offices. In these spaces, they educate and assist community members with applying for KanCare. GraceMed continues to prioritize lobby-sits during redeterminations, citing consistency in their outreach being a key component to building relationships with community members.
“If you maintain that consistent relationship and communication, then they [community members] are always going to see you as a person to go to. Not only do we help with the Medicaid application, but also when it comes to the redetermination. Once you build that relationship and that trust, consumers just come to you and say, ‘You’ve helped me before, I need help again,’” said Nava.
Lobby sits are just one way to reach enrollees. Since the start of 2023, the O&E team has attended 178 community outreach events that included school health fairs, church events, and parent-teacher conferences. Through extensive outreach efforts, GraceMed has assisted 1,407 kids, 180 adults, and 104 pregnant women in applying for KanCare since July 2022. Juven explains that if his team hears of an event that might draw consumers who qualify for Medicaid, or who could benefit from health center resources, then “that’s where we’re going to be.”
Vibrant Health: The Value of Partnerships
Vibrant Health serves around 20,000 patients across four sites in the Kansas City area. Robert Gibson, Program Coordinator for Clinical and Community Initiatives explains, “You need to stay ready, so you don’t have to get ready. That’s the saying. The community partnerships allow us to be ready, not just for Medicaid unwinding, but with a lot of things [capacity building] that came up with the pandemic.” Vibrant Health’s participation in a robust network of community partners allows them to engage with their patients and community members, ensuring the Kansas City community maintains their health coverage during the unwinding.
Vibrant Health is a lead agency on the Wyandotte County Community Health Improvement Plan (CHIP) health care access team. CHIP is a long term and systematic strategy that addresses local public health challenges. With CHIP, Vibrant Health has been able to work with different agencies serving Wyandotte County and Kansas City and joined a taskforce solely dedicated to Medicaid redeterminations. The organizations on the Medicaid taskforce represent a variety of sectors; voter rights, Latinx health, health insurance, local government, and health care.
“We’ve been able to create this task force and really mobilize and realize that we’re better together. We can all help our individual clients and patients, but then we can do more because we’re all working together for a common goal,” said Gibson.
The taskforce organized a community panel discussion to address questions and concerns about Medicaid redeterminations. They designed a “Community Conversation” and invited anyone who could be impacted by redeterminations. To get the word out, the taskforce engaged with local media organizations, including Spanish radio stations and newspapers, and connected with refugee clinics to ensure no population was overlooked.
“We created a flyer that was actually very specific to Medicaid re-enrollment, highlighting it in a way that was local, that was comfortable,” Gibson explained.
The Community Conversation aimed to address questions and concerns on Medicaid redeterminations, but Vibrant Health and the unwinding taskforce made sure to utilize existing community events and clinics as mechanisms to also spread the word. They launched a multimedia campaign that incorporated feedback from the community and partners to strengthen communication and build trust. Flyers were distributed at blood drives, cancer screenings, in pregnancy clinics and school-based health clinics. Additionally, support from the Community Health Council of Wyandotte County funded a minute-long redetermination commercial.
The Last Word
Medicaid determinations have exposed some challenges. Unclear messaging and disorganization have created a ripple effect of Americans losing coverage without being aware (it’s estimated that some four million Americans have already lost Medicaid coverage). GraceMed Health Clinic and Vibrant Health are working against that trend with highly coordinated and intentional outreach strategies and partnerships. It’s a slow and uncertain process, but one thing remains certain — the end of Medicaid continuous enrollment is one of the largest changes to health coverage in America, and health centers are essential in ensuring health equity and that no one falls through the cracks.