OCHN Notes Impact of Medicaid Disenrollment Patterns

OCHN Notes Impact of Medicaid Disenrollment Patterns
Contact: Suzanne Weinert • weinerts@oaklandchn.org • 248-758-1991
OAKLAND COUNTY, MI (March 27, 2024) – Medicaid redetermination is presenting critical funding challenges for Michigan’s public behavioral health system and the people it serves.

Public mental health providers receive funding through capitation payments. Capitation payments are fixed monthly allocations determined by Medicaid eligibility. Providers receive monthly payments for each person enrolled in Medicaid.

During the COVID-19 public health emergency (PHE), Medicaid redetermination was paused which resulted in an increase in Medicaid recipients. This rise in enrollment allowed for increased services and better mental health support throughout the state. With the PHE ending, hundreds of thousands of Michigan residents are losing their Medicaid coverage, causing a ripple effect on the public mental health system.

Funding to the public mental health system is decreasing, yet the need for behavioral health services in our community is rising.

This is compounded by the fact that Medicare rates have not kept up with inflation. The adjusted consumer price index has gone up nearly 19% over the past three years, which has greatly outpaced any increases in overall Medicaid rates during that time. In addition, incorrect Medicaid categories are causing additional stress on the system. During the redetermination process, enrollees are assigned into a Medicaid category that determines their funding allocation. Currently the state’s PIHPs and CMHs are experiencing re-enrollment determination errors causing enrollees to be incorrectly assigned.

To alleviate the impact on Michigan’s public mental health system and strengthen services and supports available to the community, OCHN is recommending:

• Adjusted Medicaid rates to offset disenrollment patterns and to accurately account for the necessary staffing adjustments and provider cost increases.
• A system that ensures that enrollees are slotted into the correct Medicaid bucket to properly empower providers to deliver needed services.

Resources are available if you or someone you know needs assistance with Medicaid Redetermination.

• Visit Michigan.gov/mibridges to manage your case, explore resource, or apply for benefits.
• Get ready for redetermination by updating your contact information, checking your mail, and completing the renewal packet if you receive one.
• Contact your case manager or supports coordinator for assistance.

If you receive notice that you or a family member are no longer eligible for Medicaid or MIChild benefits, other options are available:

• Purchase a plan on the Health Insurance Marketplace. To shop and compare available health plans, visit HealthCare.gov or call 800-318-2596 (TTY: 855-889-4325). For free local help, visit LocalHelp.HealthCare.gov.
• Enroll in Medicare. To enroll in Medicare or shop for a Medicare Advantage or Medicare Supplement plan, visit Medicare.gov or call 800-772-1213 (TTY: 800-325-0778). Michigan Medicare Assistance Program counselors also are available to provide free help with Medicare enrollment. For more information visit MMAPInc.org or call 1-800-803-7174 to speak with a counselor.
• Enroll in employer-sponsored health coverage through your employer.

To learn more about OCHN, visit www.oaklandchn.org. Non-emergency Access services can be reached at (248) 464-6363. If you or someone you know needs immediate assistance, call or text the Suicide & Crisis Lifeline at 988.