3 Cost of Care Strategies for Health Plans to Mitigate Revenue Losses From Medicaid Redetermination

Health plans must act now to protect their profits. Billions of dollars in revenue are disappearing due to changes in federal regulations that will cause an estimated 15 million Americans to no longer qualify for Medicaid coverage. The sheer size of Medicaid disenrollment is a direct result of two pieces of federal legislation. Before the COVID-19 pandemic, states were required to annually review the eligibility of residents who were enrolled in Medicaid, a process known as redetermination. That stipulation was put on hold in 2020 with passage of the Families First Coronavirus Response Act, which shielded financially strapped Americans from losing healthcare coverage during the pandemic and allowed them to remain enrolled in Medicaid.