Expanding Health Care Coverage

Project Title

Insight into How to Reduce Churning in New York’s Medicaid Program

Grant Amount

$98,175

Priority Area

Expanding Health Care Coverage

Date Awarded

July 1, 2008

Region

Outside New York State

Status

Closed

Website

http://www.lakeresearch.com

A substantial number of New York State Medicaid, Family Health Plus (FHP), and Child Health Plus (CHP) beneficiaries lose their health coverage each month. Churning (i.e., people moving in and out of public coverage programs rather than staying continuously enrolled) disrupts the health care of some of the most vulnerable New Yorkers and results in higher administrative costs for the State. Under this grant, Lake Research Partners conducted eight focus groups with former Medicaid, FHP, and CHP beneficiaries who had recently lost their public health insurance coverage because they did not complete the annual recertification process. The goal of the study was to understand why many beneficiaries do not complete the annual recertification process for Medicaid, FHP, and CHP.

This project was part of a larger NYSHealth authorization that funded a series of quick-strike analyses to help the New York State Department of Health’s (NYSDOH’s) Office of Health Insurance Programs (OHIP) find ways to streamline and expand its public health insurance programs.

Read an NYSHealth special report that contains a summary of findings from this authorization.

Read the Lake Research Partners report, Reducing Enrollee Churning in Medicaid, Child Health Plus, and Family Health Plus: Findings from Eight Focus Groups with Recently Disenrolled Individuals.

The research conducted through this grant garnered media attention, including a New York Times article on the difficulties associated with recertifying Medicaid in New York State.

Additional outcomes of the focus groups resulted in strong support of OHIP’s decision to make the public health insurance program renewal process less confusing by implementing a telephone renewal project.

New York State’s Medicaid, Child Health Plus, and Family Health Plus programs experience a substantial amount of enrollee “churning,” with at least one-third of eligible enrollees failing to complete the renewal process each year and losing State coverage. Lake Research Partners, Inc. will identify why former beneficiaries did not renew.

A substantial number of New York Medicaid, Family Health Plus, and Child Health Plus beneficiaries lose their health coverage each month. This “churning” raises administrative costs to the State and disrupts beneficiary access to health care. Studies suggest that there are many reasons why beneficiaries do not renew, including obtaining private health insurance, receiving an increase in income, moving out of state, no longer perceiving a need for health coverage, or encountering barriers in the complex renewal process.

Lake Research Partners, Inc.—a national public opinion and political strategy research firm—will conduct eight focus groups with actual individuals who did not renew their Medicaid, Family Health Plus, or Child Health Plus health coverage within the last three months. Through talking with beneficiaries who did not renew, this Lake Research will learn why beneficiaries fail to renew, understand their experience with the renewal process, and identify specific strategies to increase the number of successful renewals.