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Now is the Time to Modernize Communication in the Medicaid Program – The Health Care Blog

What do tv reveals 60 Minutes, Roseanne, Designing Ladies, and Homicide, She Wrote all have in frequent? They had been high 10 prime time reveals within the 1991 – 92 season in keeping with Nielson Media analysis. Clearly, what People need to watch has modified in 34 years. The decline in market share the foremost networks – ABC, CBS, and NBC – have skilled, and the dramatic progress of streaming companies proves the purpose. It is sensible to let individuals watch what they need to watch on the machine of their alternative, and use new applied sciences like streaming companies to entry the reveals they need to watch.  It might be silly for us to insist that People watch solely reveals from the legacy networks on conventional TVs. However that is mainly what we’re doing now after we drive Medicaid Managed Care Plans (Plans) to adjust to a 1991 Federal Regulation after they talk with Medicaid recipients.

Right here’s the issue. Federal laws referred to as the Phone Client Safety Act (TCPA), enacted in 1991, makes it very tough for States and Plans to make use of textual content messaging to speak with their members, although texting is the first, and most popular mode of communication for all People together with Medicaid recipients. TCPA requires a State or Plan sending a textual content to have permission from the individual receiving the textual content earlier than the textual content is distributed. Violations of TCPA lead to vital monetary penalties for every infraction, and penalties are tripled if the sender knowingly despatched the textual content with out consent.

Medicaid recipients are sometimes assigned to Plans, they don’t select their Plan, and consequently, in gentle of TCPA, and probably huge monetary penalties being assessed, plans have taken the place that they don’t have consent from recipients to textual content them. And that’s the drawback.

Texting is the best way most People talk as we speak. Different modalities like US mail (referred to as snail mail for a motive), telephone calls (who solutions calls anymore?), and electronic mail (more likely to go with out a response for days or perhaps weeks) are dramatically much less efficient. As a result of they’re low revenue, many Medicaid recipients typically wouldn’t have a landline, or a laptop computer. They depend on their cell phone for all their communication, together with healthcare associated communication. Texting is their most popular, and sometimes solely approach of speaking.

As Founder and CEO for SameSky Well being, I spent over a decade working with Plans to assist them have interaction their members and navigate them into healthcare on the proper time and the correct place. Many times, we discovered after we might maneuver across the outdated restrictions TCPA positioned on Plans, we obtained increased engagement which translated into extra effectively youngster visits, extra breast most cancers screenings, extra diabetes (a1c) screenings, and so forth. Utilizing fashionable instruments of communication is a approach of assembly individuals the place they’re. It builds belief and results in higher well being outcomes. However sadly, due to TCPA, we weren’t capable of textual content members in most cases.

What has been a major drawback shall be made exponentially worse when Federal Work Necessities are carried out as now appears probably. A Federal Medicaid Work requirement will dramatically improve the necessity to modernize how States and Plans talk with Medicaid recipients. Compliance with TCPA is standing in the best way of this modernization. And if it’s not fastened, many, many individuals will lose their Medicaid advantages for purely procedural causes.

To enhance well being outcomes, enable environment friendly communication to confirm work standing,  and supply twice yearly redetermination info, States and Plans should be exempted from the outdated provisions of TCPA. Senate motion on, and ultimate passage of the Reconciliation laws affords the most effective alternative to get an exemption from TCPA handed and signed into legislation.

The time to behave is now.

So lets concentrate on (1) getting the exemption language within the Senate model of the Reconciliation laws, (2) working with HHS and CMS to make sure publish laws steerage directs States and Plans to incorporate texting as a greatest follow when implementing work requirement applications and speaking with recipients extra typically, and (3) implementing a media technique to construct assist for utilizing fashionable expertise to create simpler extra environment friendly methods for Medicaid recipients to adjust to the brand new work necessities.

We’ve two months – June and July – to get motion on an exemption within the Senate, and the rest of the 12 months to affect Administration steerage on work requirement applications.

Medicaid beneficiaries would be the greatest winners if we succeed as a result of an exemption is a key technique to scale back pointless lack of Medicaid advantages.

What are you able to do? Name your Senator and ask them to assist modernizing how States and Plans talk with Medicaid recipients. And please share this weblog publish together with your community.

Abner Mason is Chief Technique and Transformation Officer for GroundGame Well being. He serves on the Board for Manifest MedEx, California’s largest well being info trade, is Vice-Chair of the Board for the California Black Well being Community, and is a member of the Nationwide Fee on Local weather and Workforce Well being. Listed below are are simply some of articles and interviews he has printed over the previous 10 years pushing for States and Plans to have the ability to textual content Medicaid recipients. 


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