Closing the divide: Highmark Health Options addresses health care disparities through redetermination outreach

• Highmark Health Options partners with Network Connect on statewide redetermination campaign.
• Grassroots outreach addresses barriers to access and care.
• Tens of thousands of Medicaid beneficiaries engaged through targeted awareness and education efforts.

WILMINGTON, Del. (October 7, 2024) — Last August, Highmark Health Options launched a statewide campaign to raise awareness and educate Delaware Medicaid enrollees about the return of pre-pandemic renewal guidelines, also known as redetermination. Partnering with Network Connect, a Wilmington-based community organization specializing in grassroots outreach, the program recently completed its nearly yearlong activation having engaged more than 25,000 Delawareans living in underserved communities.

Through existing partnerships with frontline community organizations and nonprofits — including Scholars Turf Youth Lounge, Love Hope Rescue Mission and Cornerstone Community Center — and attendance at town halls, small group meetings, community events and other types of gatherings in cultural centers throughout the state, Network Connect community messengers actively interacted with Medicaid participants about redetermination during the outreach campaign. In addition to educational materials, community messengers carried tablets to assist with answering questions, accessing state websites, and completing and submitting Medicaid renewal information.

The results of the Network Connect and Highmark Health Options collaboration include:

• Outreach in all three counties
• Nearly 12,000 homes canvassed
• 10 dedicated redetermination community events
• Redetermination outreach at Network Connect non-programmatic community events
• Nearly 200 Delawareans assisted through application assistance

“Redetermination was an unprecedented event with the potential for significant health care disruption. Thanks to the hard work of many, this initiative accomplished everything we wanted it to and more for all state Medicaid enrollees,” said Todd Graham, president, Highmark Health Options. “Working in conjunction with state efforts, we raised awareness and understanding of redetermination and, where needed, submitted renewal information. This helped minimize the number of enrollees improperly losing Medicaid coverage for avoidable procedural reasons. We also provided hands-on assistance for those no longer qualifying to transition to a different health plan to avoid a coverage gap.”

Medicaid enrollment nationwide increased by nearly one-third during the public health emergency to 94 million enrollees prior to the start of redetermination. Early last year, pandemic-era federal flexibilities began a yearlong phase out resulting in millions of individuals, including children, losing Medicaid coverage. There were nearly 300,000 Medicaid participants in Delaware at the start of redetermination, with nearly 65,000 losing Medicaid coverage through the redetermination process as of an April 2024 report by the Department of Health and Social Services.

Procedural disenrollments have been a concern throughout the redetermination process. Procedural disenrollments occur when beneficiaries fail to complete the renewal process through incomplete submissions, submissions that are not received by the state on time, or the state lacks proper contact information. Procedural disenrollments may result in individuals eligible for Medicaid losing coverage.

According to a July 2024 report by the Kaiser Family Foundation, 69% of all redetermination disenrollments nationally have been procedural disenrollments. In the same report, Delaware had one of the lowest procedural disenrollment rates in the nation, 10 percentage points lower than the national average.

“This project was one that really informed the community,” said Cierra Hill-Hopkins, executive director, Network Connect. “It also demonstrated the power of collective impact. We are thankful to the partners and to Highmark Health Options for this effort.”

Financial support for the initiative was provided by the Highmark Health Equity Fund.