CareSource supports its members through unprecedented Medicaid redetermination effort

Because of a federal COVID-19 rule, all Medicaid members kept their coverage throughout the pandemic without having to go through annual eligibility requirements. But now that the country is returning to business as usual, once again Medicaid recipients are being screened for need based on income, residency and other factors.

CareSource is taking a proactive role in helping members understand the process and update their eligibility in the states CareSource operates a Medicaid plan. Getting through the redetermination process successfully helps ensure that eligible beneficiaries continue to receive necessary assistance. CareSource is working with state Medicaid offices in a variety of ways to help secure health care access for those who need it most.

CareSource care managers meet with members to help them with their Medicaid eligibility paperwork.

In Georgia, CareSource's support and resources help ensure that the redetermination process is smooth and timely, preventing any disruption in health care coverage.

• Each department that engages with members – Care Management, Life Services, Population Health, Quality, Customer Care – reminds members about updating their information and completing the renewal package when prompted to by the state.
• CareSource Georgia is partnering with Walmart stores and its clinics to provide eligibility experts and post information in stores to highlight the process for redetermination for customers.
• CareSource is providing laptops and staff at many back-to-school events to help members complete their redetermination paperwork on the spot.

“CareSource plays a vital role in guiding Georgia’s Medicaid beneficiaries through a smooth redetermination process, providing essential support and resources to ensure uninterrupted healthcare coverage,” said Jason Bearden, president of CareSource Georgia. “Through strategic partnerships with Walmart and on-site assistance at Back-to-School events, CareSource is committed to empowering its members with the necessary tools to complete their redetermination applications promptly.”

In Ohio, CareSource is working diligently to help members know how to gather the necessary documentation for a successful application.

• CareSource works closely with the Ohio Department of Medicaid and hospitals like the Cincinnati Children’s Hospital and Nationwide Children’s Hospital, sharing data and collaborating with these providers to increase successful outreach to members.
• CareSource hired an outside partner, Centauri, to make targeted calls and send letters, emails and voice messages with a goal to connect at-risk members with live agents who walk them through the eligibility process.

“Leveraging our provider partnerships helps us know what members need to take action so we can have as many face-to-face conversations as possible,” said Steve Ringel, CareSource Ohio president. “Once we are engaged with the member, then the real opportunity starts. We can help them understand what they must do, when they must complete, and even assist by helping them navigate the renewal form. Even if the member is no longer eligible for Medicaid, CareSource is a qualified health plan on the marketplace so we can help ensure there is no gap in their care.”

A CareSource care manager meets with a member in her home.

CareSource collaborates with the Indiana Family & Social Services Administration to ensure members have the tools and information needed to complete the redetermination process effectively. CareSource’s eight life coaches and 48 care managers covered all 92 counties in Indiana. They routinely assist members with the redetermination process in a one-on-one setting.

“Redetermination has been a priority for all of us,” said Steve Smitherman, CareSource Indiana president. “We’ve done some unique partnerships with community organizations. Recently, we worked with Shepherd Community Center, and they went door to door and were able to help 70% of at-risk members identified update their information.”

Similarly, in Arkansas, care coordinators meet one-on-one with every Provider-Led Arkansas Shared Savings program member and their caregivers to help them file the correct documentation on time.

“I am so proud of how our whole team has come alongside members and their caregivers,” said David Donohue, president of CareSource PASSE. “As of July, we’ve been able to work directly with more than 450 people, or almost 15% of our membership, to renew their information with the state.”