Jul 11, 2023 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Insights from the first four months of redetermination are showing impacts to the Medicaid population. According to the latest Medicaid renewal data captured in the KFF Medicaid Enrollment and Unwinding Tracker, over 3.7 million Americans across 41 states have lost their coverage.1 The challenges expected from the redetermination process around completion of paperwork are yielding almost 3 out of 4 individuals reportedly dropped due to incomplete paperwork or missing required documentation. [1] Data as of August 1, 2023 As U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra stated in his June 12th letter to U.S. Governors, “as full Medicaid renewals begin, it is critically important to ensure that individuals do not lose coverage due solely to administrative processes.” If beneficiaries submit incomplete redetermination paperwork, states are required to contact the beneficiary and work through information fields that are missing. This may cause multiple rounds of submissions in order to complete the redetermination process paperwork. For beneficiaries that are non-responsive, states will have to manage multiple rounds of outreach to the individual. This overall increase in additional support for enrollment departments comes at a time when many are experiencing staffing shortages and workload capacity issues. What challenges do beneficiaries face when completing their paperwork? This is the most significant question that states need to consider when determining the best way to support beneficiaries and lower the administrative burden. Beneficiaries who do not complete their redetermination paperwork typically experience one of these challenges: They are lacking awareness of the process and are not responding to outreach notices due to not opening mail. They are lacking awareness of the process and are not receiving outreach notices due to having incorrect

Mar 29, 2023 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions April 1st is upon us and states are starting the redeterminations process for Medicaid, which has been referred to as one of the “biggest administrative burdens” states have faced to date from the pandemic. From now through the end of the year, the impacts to Medicaid beneficiaries as well as internal state operations, providers, and stakeholders will come to the forefront. The early months will bring to light challenges and broader impacts than perhaps the most thoughtful and deliberate state plans could have anticipated. The good news for states, however, is that they do not have to face these challenges alone. How can partnership play a role in resolving redeterminations? States are looking to their long-term partners who currently have roles in their day-to-day Medicaid operations. These partners know the state policies and practices, have daily communications with beneficiaries, providers, and stakeholders, and are viewed as an extension of the state’s team in planning and problem-solving communication challenges, as well as other emerging challenges. Partners perform various functions for states including claims processing and enrollment, as well as a variety of clinical operations ranging from utilization management, case management, and care coordination, to clinical assessments for waiver programs, provider network credentialing and enrollment, and numerous other functions. Many partners work with numerous states and some have a national footprint, placing them in a unique position to bring ideas to the discussion, share experiences from other states, and help states plan their paths forward. Opportunities to Overcome Challenges with Awareness-Building Efforts Raising beneficiary awareness is the first of many challenges to overcome. For example, in December 2022, nearly two-thirds (64.3 percent) of adults enrolled in Medicaid or with an enrolled spouse, partner, or ch

Feb 11, 2022 – This article originally appeared in the February 11, 2022 issue of Forbes India. CNSI Managing Director Gaurav Maini uses his healthcare technology background to improve lives with a unified global team. As an executive with Epic Systems in Wisconsin, United States, Gaurav Maini was no stranger to on-site technology implementations. When his own children were due to be born, Gaurav went to the local hospital to personally test the electronic health record systems that would empower his family and their medical providers. This fundamental connection to the humanity of healthcare technology now drives Gaurav’s work as Senior Vice President and Managing Director for India at U.S.-based CNSI. CNSI delivers health information technology solutions and customizable products to state and federal agencies in the United States, where it is headquartered. With a major technology center in Chennai since 2004, CNSI employs a world-class team of engineers, program managers, and subject matter experts with large-scale technology implementation experience. When CEO Todd Stottlemyer selected Gaurav Maini to lead CNSI’s India operations in October 2020, he stated, “Gaurav knows what it takes to build and deploy solutions to help us improve health outcomes, better manage population health, and bend the cost curve.” Prior to CNSI, Gaurav Maini spent eight years as Managing Director of Philips VitalHealth Asia Pacific, establishing Philips as a leading provider of solutions focused on health data, coordination of care, and patient and clinician engagement. He is passionate about the confluence of technology and healthcare. “I get to follow that passion through CNSI’s vision: to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health and social services outcomes and reduce costs,” says Gaurav. Gaurav has extensive experience with the complexities and costs of healthcare technology systems in the U.S. After earning h