With the recent announcement from the Biden Administration stating that the Covid Public Health Emergency will be ending on May 11th, there will be a significant impact on the healthcare industry and potentially other sectors as states and the federal government revert back to pre-pandemic rules and regulations. One of the first and most important developments will be the redetermination of member eligibility for Medicaid and Medicare. Members who were previously covered under Medicaid or Medicare have not had to resubmit paperwork for eligibility for the last three years. This will pose a challenge for some payers and providers, as demographic and member information on Healthcare data may have changed over the past three years, affecting their eligibility.
How will this announcement affect member eligibility? According to Jeff Stafford, the CEO of UHC Nebraska Community and State, “You may find out you were supposed to file your paperwork (for Medicaid or Medicare Eligibility), and due to some unseen reasons you didn’t, but you are at the doctor, now you need healthcare only to find out that you don’t have it. This is a crisis.” As such an undertaking that this will present, Jeff mentions the importance of having a Data Analytical solution to help with communicating to members to re-apply for coverage, “Find ways to use the data to score and surface contact mechanisms. Make sure you are reaching people and engaging partners, whether that is your church or community organization to help get the message out.”
What can you do in today’s day and time to ensure your next steps are the right ones?
- SpringML conducted a webinar recently in anticipation of the lifting of the Covid Public Health Emergency Designed to help companies prepare for these changes, you can find the webinar on Data for the Clinical journey: Pairing Analytics with Health Cloud for Data-Driven Success here
- It’s a great time for companies to take a look at Snowflake, which is the next-generation cloud data warehouse. Healthcare data is growing and efficiencies are going to be needed in order to process the immense amount of data that is going to now be needed in the Healthcare sector. We have already seen some significant improvements through the Snowflake implementation at UHC Dental and the Optum Growth Office. This will continue to grow as the Healthcare sector continues to use Healthcare data to analyze member and industry trends
