Close access gaps by enhancing awareness of CMS benefits and programs
Consumers face significant obstacles in accessing and navigating CMS programs, leading to a lack of awareness and missed opportunities for healthcare access and equity. Factors such as difficulty accessing government information, lack of primary care providers, provider unawareness of benefits, and a fragmented referral process contribute to these challenges. As a result, patients are unaware of the benefits and treatments they are eligible for, preventing them from taking full advantage of their health plans.
One of the main issues is the complexity surrounding information about benefits. Eligibility criteria, application processes, and variations by state make it challenging for patients to understand their available benefits. Currently, benefits are scattered across various sources such as legislation, agency guidance, websites, and social media, lacking a centralized repository. This communication complexity creates unnecessary barriers for patients who need to navigate the system in order to receive the benefits they are entitled to.
A recent survey conducted among caregivers in the United States revealed that 33% of them identified a lack of awareness as the main barrier to accessing benefits. Another 29% struggled with enrolling in programs or understanding their eligibility. Caregivers also face the burden of time-consuming paperwork, as separate documents are often required for each benefit. To address these challenges, technology-enabled startups have emerged as a solution. These startups offer user-friendly web applications that gather information about various benefits, verify eligibility, and simplify the enrollment process. With these platforms, caregivers can access tax credits, state programs, health plan reimbursements, and other benefits in one centralized location. They also receive proactive recommendations about benefits they may not have known they were eligible for.
Furthermore, the unwinding of the Public Health Emergency (PHE) has resulted in over 3.8 million individuals losing their Medicaid coverage. State governments will no longer receive enhanced federal funding to cover Medicaid beneficiaries during the PHE. Unfortunately, many individuals were not notified of their loss of eligibility, and it is estimated that 7.9% (6.8 million) will lose Medicaid coverage despite remaining eligible. Digital health platforms have the potential to streamline enrollment and re-certification for Medicare members in all state and federal programs they qualify for. By partnering with these platforms, CMS can communicate with individuals about their benefits eligibility, reduce health insurance churn, and improve the utilization of health benefits.
To further enhance accessibility and awareness, CMS can also collaborate with companies like Google. Google recently improved its search engine to assist users searching for information about re-enrolling in Medicaid. CMS can leverage these technological capabilities to improve consumer awareness about Medicaid redeterminations, simplify the enrollment process, and provide accurate information about re-enrollment in different states.
In conclusion, it is crucial for CMS to address the lack of awareness and barriers that consumers face in accessing and navigating benefits programs. By embracing technology-enabled startups and collaborating with digital health platforms and companies like Google, CMS can enhance healthcare access, promote equity, and ensure that individuals receive the benefits they are entitled to.
