State Medicaid agencies strengthen their workforces as the unwinding begins

As the Medicaid redetermination process starts, state Medicaid agencies are taking steps to increase their capabilities as their workforces face an increased workload, according to an AHIP issue brief.

In February 2023, states began the process of redetermining whether each of the more than 90 million Americans currently enrolled in Medicaid are still eligible for the program, with eligibility coverage decisions starting April 1. A recent analysis from the Urban Institute and the Robert Wood Johnson Foundation concluded that 18 million people could lose access to Medicaid coverage.

A new issue brief from AHIP describes some ways the states are supporting people through the Medicaid redetermination. Here are some examples of how states are strengthening their Medicaid agencies' workforces.

Alabama: Alabama has taken several measures to enhance eligibility staff capacity including bringing back retired state employees, hiring contract workers, and filling vacancies quickly. The state is redistributing staff as needed, with the ALL Kids CHIP staff earmarked to assist in processing modified adjusted gross income applications, which will help with staff capacity to work on redeterminations.

Colorado: In Colorado, eligibility staffing decisions are made at the county level, however, the state is taking actions to support county eligibility staff. The Department of Health Care Policy and Financing secured funding through a state budget amendment to establish an Overflow Processing Center to assist the counties in completing eligibility redeterminations when there is a backlog, or an overflow of applications. Counties can submit a Google form to request assistance with processing redeterminations and various other tasks. Overall, the assistance provided from OPC will ensure that the state is following the federal and state regulatory guidelines for timely processing of applications and renewals.\

Oregon: To provide supplemental call center support for redetermination, Oregon has contracted with Performance Health Technology to support their eligibility staff in completing redeterminations. PH Tech triages phone calls coming from Medicaid enrollees, answering simpler questions themselves and sending along more complex questions to eligibility staff with greater expertise.

Virginia: With the goal of enhancing the Medicaid agency workforce prior to beginning of redeterminations, Virginia created an Agile Taskforce in May 2022. The task force
comprises temporary workers contracted to augment existing eligibility workforce by assisting local agencies in clearing backlogs and making necessary changes and corrections to prepare for the redetermination period. The Department of Social Services also sought funding to support payments of staff doing overtime and the budget approved in June 2022 authorized the use of federal American Rescue Plan Act funds for this purpose.