One of the major issues we’re watching in 2024 is how the Medicaid renewal process is affecting health centers and their patients. In the spring of 2023, the federal government began rolling back the pandemic policy that allowed people to stay on Medicaid without renewing each year. This has required patients to reapply for Medicaid, known as Medicaid “redetermination” or “renewal.” Below is the latest in a series of blogs looking at how health centers are responding.
Oklahoma was one of the first states to begin the Medicaid renewal process after three years of continuous Medicaid enrollment during the COVID-19 pandemic. As of November, the state has renewed coverage for 218,000 Oklahomans while disenrolling 225,000. Community Health Centers in Oklahoma alone served 146,000 Medicaid patients in 2022. Of the total health center grantees in the state, 76% are in rural communities.
These health centers are implementing outreach strategies to make technology and updated information and guidance on re-applying for health coverage more accessible to communities where these resources aren’t always widespread. Two health centers in Oklahoma spoke with NACHC about the impact of renewals at their health center and in their communities.
Great Salt Plains Health Center’s Mobile Unit Outreach Ensures Oklahomans Experiencing Homelessness Renew Medicaid Coverage
Great Salt Plains Health Center (GSP Health) serves around 12,000 Oklahomans in the northwestern region of the state. We had the opportunity to talk with Lindsey Elston, the Enrollment Navigator at GSP Health to learn about the health center’s outreach and enrollment efforts during Medicaid renewals.
Renewals began in Oklahoma in May and GSP Health prepared by developing a list of patients currently on Medicaid as well as those who’ve had SoonerCare (Oklahoma Medicaid) in the past. These patients were contacted through the health center’s text messaging system as well as through individual phone calls. Through this outreach, Elston says she’s been able to help several GSP Health patients re-enroll in SoonerCare over the phone and in-person, but there are still patients and community members that are harder to reach who she’s particularly concerned about.
There’s a large population of people experiencing homelessness in one of GSP Health’s communities, and to make sure these folks know about Medicaid renewals, the health center sends out its Medical Mobile Unit (MMU) three times a week to do outreach. There are several stops the MMU makes throughout the week to provide preventive and outreach services to people experiencing homelessness. Weekly, the MMU stops at Our Daily Bread in Enid and the Woodward Food Bank.
The MMU also makes regular stops in rural Oklahoma towns that surround main GSP Health clinics. At those sites, Lindsey is able to meet with folks, hand out flyers on renewals, and even help them renew their coverage right then at their mobile appointment.
On average, Elston sees 53 patients a month for Medicaid enrollment on the MMU, and that number continues to increase as renewals progress. When she’s not on the MMU she is in a GSP clinic assisting patients in person or over the phone with their renewal, helping them find marketplace coverage, or even walking folks through their employer-sponsored benefits.
Word spread quickly throughout the community about Lindsey’s ability to help people enroll and renew their health care benefits, Elston explains.
“They use word of mouth a lot. Usually, when I can help one, they’ll go out and spread the word, and then somebody else will come.”
In 2021, collectively health centers provided care to over 5,000 Oklahomans experiencing homelessness. The National Health Care for the Homeless Council explains that poor health is major cause for homelessness. Health centers serving all patient populations in their communities have multi-pronged strategies to connect and coordinate services for unhoused patients and community leaders like GSP Health take it one step further by building trust and keeping the most medically underserved connected to coverage that they deserve.
Integrated Care Specialists at Health & Wellness Center of Oklahoma Keep Patients Connected to Coverage
Health & Wellness Center of Oklahoma (HWC) serves around 30,000 patients across seven locations, three pharmacies, and two residential substance use recovery facilities. Our team spoke with Brooke Lattimore, Chief Operating Officer and Clark Grothe, Behavioral Health Director of HWC to learn about their use of Integrated Care Specialists (ICS) during Medicaid renewals.
The Oklahoma Health Care Authority, the agency that governs Oklahoma Medicaid, sent out a series of letters to Medicaid beneficiaries alerting them of the end of continuous enrollment and the need to renew coverage. Lattimore told us that patients were quick to reach out to HWC with questions about renewals, and ISCs were tasked with being the “go-to folks for answering those questions.”
Integrated Care Specialists are an indispensable part of HWC. They are embedded in each of the health center’s locations and interact with patients virtually when needed. Since renewals have begun, patients visiting any HWC site who have lost coverage or are about to lose coverage meet with an ICS who helps them fill out the renewal form during their appointment. Oklahoma’s renewal portal determines eligibility immediately, which means renewed coverage is effective immediately and can be utilized retroactively for up to six months. Additionally, if a patient ends up being ineligible after completing the renewal process, ICSs can then assist in finding coverage on the Federal health insurance marketplace.
ICSs are a critical part of the HWC team under normal circumstances, and Medicaid renewals underscore the necessity of their role. Recent data shared by HWC shows that the health center’s ICSs have assisted 282 patients by providing them information on how to apply for Medicaid or Marketplace coverage and nearly 350 individuals through the application process. It is not uncommon for health center patients to be juggling many stressors in their day-to-day lives; on top of it all, this time of Medicaid renewals can be overwhelming, and ICSs make the process less daunting.
“That’s the beauty of having [Integrated Care Specialists]. Our patients know, ‘Hey, whatever is challenging me in this moment whether it’s my health care, my oral care, whatever it is, someone at the Health and Wellness Center is gonna take care of me.'”
Clark Grothe
The Future of Medicaid in Oklahoma
While Medicaid renewals in Oklahoma and nationwide have presented a variety of challenges and unnecessary loss of coverage for many, the future of Oklahoma’s Medicaid program and its enrollees is promising. SoonerCare is expected to transition to managed care come spring of next year. Larger health centers like HWC are making sure Community Health Centers of Oklahoma have a seat at the table with the Oklahoma Health Authority and the health plans that will serve as the state’s Managed Care Organizations (MCOs).
As health centers in Oklahoma care for a majority of the state’s Medicaid beneficiaries, a positive and strong partnership between the new MCOs and the state’s health centers is an opportunity to improve primary care access and increase healthy outcomes among hundreds of thousands of Oklahomans.
Share what your health center is doing and learn about what other health centers are doing during Medicaid unwinding, by signing up for Medicaid Unwinding and the Importance of Outreach & Enrollment, a pre-conference session before NACHC’s 2024 Policy & Issues Forum. NACHC’s Federal Policy team is hosting this session to allow outreach and enrollment experts to gather in person to share best practices during Medicaid renewals, network, and learn from other health center, PCA, and HCCN peers.