Technology Upgrades Key to Higher Enrollment and Reducing Gaps in Coverage During Medicaid Redeterminations

MOUNTAIN VIEW, Calif., Feb. 8, 2023 /PRNewswire/ — As the record-breaking open enrollment period for plan year 2023 came to a close, GetInsured, the leading state-based health exchange (SBE) technology platform provider, enabled two-thirds of SBE enrollments through their eight state clients — Idaho, Pennsylvania, New Jersey, Virginia, California, Minnesota, Nevada, and Washington. 16.3 million Americans signed up for Affordable Care Act coverage and 4.1 million of those enrollments came from state-based exchanges, contributing to a record low uninsured rate. With the continuous coverage requirement of the Public Health Emergency phasing out this spring and the beginning of Medicaid redeterminations, the SaaS technology company is working closely with customers to prepare for this transition and ease the process for eligible consumers to enroll in affordable health insurance on SBEs.

State-based exchanges provide states with greater autonomy and flexibility to institute state-specific policies and programs that support higher enrollment and lower uninsured rates. GetInsured’s SaaS-based technology enables SBEs to cost-effectively deploy solutions that improve the consumer experience and make it easy for consumers to enroll. The company’s technology also allowed for states to successfully auto-renew over 90 percent of eligible applications, contributing to higher enrollment. For the consumer, this provides continuity of coverage without having to go through the plan selection process again, unless they choose to do so.

Enrollment numbers at Your Health Idaho, a GetInsured customer since 2014, reached an all-time high of nearly 94,000 sign-ups, with more than 21,000 new enrollees, and a record 99.1 percent auto-renewal rate. Thanks to technology upgrades that transitioned the application and eligibility process from Idaho’s Medicaid agency to the exchange, consumers experienced an improved and streamlined process that made enrollment easier than ever. With the advantage of real-time eligibility determination and self-service capabilities, three quarters of enrollments were completed without the additional assistance of the call center or marketplace staff. In New Mexico, GetInsured’s interim leadership led to the operational and technological stabilization of the exchange, which resulted in a significant enrollment increase of nearly 23 percent, far outpacing the national average.

“Making the enrollment process user-friendly, while keeping costs low for both Idahoans and the state of Idaho are our top priorities at Your Health Idaho. GetInsured’s proven and innovative SaaS platform and wealth of experience working with state-based exchanges continues to make them an integral partner to Your Health Idaho,” said Pat Kelly, Executive Director, Your Health Idaho. “The system changes implemented in advance of open enrollment this year, such as real-time eligibility, made enrollment easier and more streamlined for consumers, and we are pleased with Idaho’s final enrollment numbers and effectuation rates. As we prepare for the end of Medicaid continuous coverage requirements, these same improvements will contribute to our goal of helping people stay covered as redeterminations begin, minimizing gaps in coverage.”

Technology Upgrades to Help Reduce Coverage Gap During Medicaid Redeterminations

On the heels of the successful 2023 open enrollment, GetInsured is already working with state clients to support the process of Medicaid redeterminations. Through the redetermination process, an estimated 18 million Americans are at risk of losing their health insurance. Anticipating the large number of consumer accounts that will be transferred to exchanges from Medicaid departments, GetInsured is implementing state-specific technology upgrades that will streamline the handoff process and help reduce the coverage gap for millions of Americans who will no longer be eligible for Medicaid. These upgrades include the following:

  • Functionality to identify consumers who are transferred to the exchange based on the end date of their Medicaid/CHIP coverage, to minimize gaps in coverage
  • Automatically determine eligibility for subsidized and non-subsidized exchange plans
  • Automatically open special enrollment periods that enable consumers transferred from Medicaid to enroll in exchange plans without needing to provide proof of an eligible life event
  • Ability for these consumers to provide a retroactive coverage start date and avoid gaps in coverage

“The landscape for public sector health care agencies has been in constant flux in recent years, and this year was no exception. Despite these challenges, we are proud to be a trusted partner of state-based exchanges across the country who work tirelessly to lower uninsured rates,” said Shankar Srinivasan, Chief Technology Officer and General Manager at GetInsured. “With Medicaid redeterminations on the horizon, GetInsured’s technology and infrastructure for SBEs help our client states be more prepared to manage shifts in coverage.”

About GetInsured

GetInsured is a leading technology provider for state-based exchanges, offering an ACA-compliant cloud-based SaaS technology platform and integrated consumer assistance center operations. GetInsured’s roster of clients includes Georgia, Pennsylvania, New Jersey, Nevada, California, Virginia, Minnesota, Idaho, and Washington. The award-winning SaaS platform processed enrollments for 2.7 million consumers for plan year 2023, which represents approximately two-thirds of all state-based marketplace enrollments.