With enrollment at an all-time high and only increasing, state Medicaid programs and the health plans they contract with need to prioritize a few key areas of the beneficiary experience.
A report conducted for the Medicaid and CHIP Payment and Access Commission found that while many Medicaid beneficiaries across the demographic spectrum are grateful to be covered, the experience still has a lot of friction that states, the federal government and private insurers with Medicaid plans can improve -- especially if more people are going to be covered at lower per-capita costs.
In Chicago, Denver and Portland, Oregon, researchers from PerryUndem interviewed six focus groups: two with Latino enrollees, two with young adults 18-34, one with parents of young children and one with childless adults.
Prior to their recent enrollment in Medicaid, most of those in the study were not regularly seeing a doctor or were putting off care, while others were incurring medical debt. Preventive care especially seemed out of reach for those without insurance, and some participants were going years without a primary care visit, according to PerryUndem researchers.
Now that they have Medicaid, the participants said they are happier and less anxious. Some cited a recent diagnosis, accident or previously-ignored ailment that have been treated since they obtained Medicaid coverage. And despite a range of technology problems for those who signed up for Medicaid via insurance exchanges, enrollment and choice of Medicaid plans was not overly difficult, the study authors noted.
But many have lingering worries and confusion.
Some of the participants "feel there is a stigma attached to Medicaid and have concerns that their care will be lower quality," the researchers wrote.
And most of the participants who enrolled in Medicaid for the first time know little about what the program covers, even months after entering it.
Most remain confused about which services are covered, limitations on providers or treatments, cost-sharing, and finding doctors for primary or speciality care -- and only some received an explanation of benefits packet after enrollment.
Looking forward in the short-term, many of the beneficiaries interviewed want to stay covered by Medicaid as long they remain eligible, but not all of them know they have to go through a renewal process, the researchers found. That is one area to focus on.
In the long-term, as enrollment technology improves, Medicaid managed care organizations and state administrators should focus on simple approaches to beneficiary education -- like emailed benefit explanations, Internet presentations, social media, community-based events or outreach and support calls.