Virgin Pulse Helps Health Plans Reach Vulnerable Populations Facing Medicaid Redetermination

Company provides strategic, actionable solution for health plans to reach Medicaid members before it's too late

PROVIDENCE, R.I., Feb. 14, 2023 /PRNewswire/ -- A potential 15 million Americans are at risk of losing their healthcare coverage when the Medicaid Continuous Enrollment Requirement expires on March 31, 2023. Engaging Medicaid members is a long-standing challenge for health plans, and recertifying them (called redetermination) has not been required since early 2020 when the U.S. public health emergency created by COVID-19 began. Virgin Pulse, the leading global digital-first health, wellbeing, and navigation company, provides the data-driven, multi-channel technology that aligns with Centers for Medicare & Medicaid Services (CMS) guidance for communicating with members for redetermination. Currently working with health plans across the country, the company has launched a free multimedia toolkit to guide and support executives as they prepare to tackle Medicaid redetermination.

Medicaid/CHIP enrollment has increased by approximately 20 million people during the pandemic, an increase of nearly 28% – many of whom have not had to participate in redetermination until now. Health plan leaders need to have an outreach strategy in place to get people's correct contact information, including their mailing address, and help them complete the eligibility process or enroll in an available marketplace plan. CMS is "strongly encouraging" specific communications techniques to reach out to the 83 million Medicaid and CHIP enrollees at risk of losing coverage. CMS recommends using multiple channels like text, phone, mail, and email to reach beneficiaries who need encouragement to complete and return enrollment forms. Using a multi-channel communications strategy that includes text messaging and IVR calls is of critical importance since 97% of American adults own a cell phone of some kind regardless of socioeconomic status, according to Pew Research.

Reaching Even the Hardest-to-Reach Members

Multi-channel communications campaigns are proven to effectively reach diverse populations. The ability to identify the highest risk members allows managed care plans to focus on the most vulnerable. Combined with Virgin Pulse's proprietary consumer database and advanced analytics, the company can identify the most at-risk Medicaid-eligible members who are unlikely to recertify and then execute the appropriate campaign strategies to reach them. Using this strategy, the company worked with a regional Medicaid plan to identify 25% of the most at-risk members and drove a 39% increase in redetermination.

Virgin Pulse's AI-powered outreach solution VP Activate enables health plans and other organizations to connect with their populations more nimbly and proactively to drive critical health actions. It determines individual needs and barriers to closing gaps in care or other critical actions, and uses a surround-sound approach to drive successful outcomes via digital and offline channels. VP Activate is driven by the industry's most intelligent activation engine, which includes lifestyle and social determinants of health data from 275 million people. This data, combined with predictive models, drives a 55% higher activation rate than outreach based on client-owned data alone. 

"The extended deadline is meant to ensure that vulnerable members won't lose coverage and not know it – meaning that health plans must act now before time runs out. However, the reality is that health plans do not have the technology or expertise in-house to reach all these members to this extent," said Salem Shunnarah, EVP and GM, Health Plans and Systems for Virgin Pulse. "This is why plans are turning to us to help them fill this gap and ensure members maintain their health coverage. Having reached two billion people – and counting – with critical health information, Virgin Pulse has the experience and scale to improve redetermination rates and retention in a matter of weeks."

Free Resources Available to Help Payers Create a Redetermination Strategy

Virgin Pulse has curated a toolkit of free resources to inform health plan leaders about how to best plan for Medicaid redetermination and effectively reach members. These multimedia resources include an on-demand demo that provides the ability to see VP Activate in action, as well as a case study on how a regional plan improved its redetermination efforts. The toolkit also includes an eBook, blog posts, buyer's guide, and an infographic that provide readers with actionable advice about preparing for redetermination, selecting a partner, and spotlighting secure texting as an essential channel to help Medicaid members recertify.

About Virgin Pulse

Virgin Pulse is the leading digital-first health, wellbeing, and navigation company that empowers organizations across the globe to activate populations, improve health outcomes, and reduce spend in an era of accelerating cost and complexity. Virgin Pulse's Homebase for Health® connects data, people, and technology to deliver high tech, human touch experiences that engage and reward individual journeys. Virgin Pulse impacts over 100 million people across 190 countries by helping Fortune 500, national health plans, and many other organizations change lives – and businesses – for good. For more tips and insights, connect with us on Twitter or LinkedIn.

SOURCE Virgin Pulse