Estimated impact on Philadelphia residents and health providers
City health leaders estimate that on the lower end, about 73,000 people are at risk of losing Medicaid coverage. That will include people who are already working or volunteering 80 hours a month due to missing eligibility paperwork and documentation issues, experts say.
However, the actual number could be as high as 90,000 people, according to Donna Bailey, chief executive officer of Community Behavioral Health. CBH is a not-for-profit organization that manages the city’s behavioral health services network for the Medicaid population.
The organization is using existing client data to identify people who are most at risk of losing Medicaid next year and working with mental health providers in the city who can proactively reach out to these people, Bailey said.
There’s also a lot of work to do in helping people understand how Medicaid changes apply to them. That starts with educating people about what kind of health insurance they have, she said.
“A lot of people don’t even know they have Medicaid,” Bailey told City Council members Monday. “They think they have Health Partners or Keystone or Geisinger or UPMC for You or United — that’s Medicaid.”
Public service announcements and awareness campaigns will target people with these plans, Bailey said. CBH also plans to hold in-person outreach events across the city beginning June 13 in partnership with local community service providers like Concilio Philadelphia, based in North Philadelphia.
“We really want to go to those neighborhoods where we know we have a high percentage of both eligible and utilizing members, prioritizing those first,” she said.
Fallout will affect provider organizations
City organizations and agencies say they’re also worried about how the Medicaid changes and anticipated enrollment losses will affect community health and mental health providers, whose revenue directly depends on the number of people they serve.
More than 810 community behavioral health jobs in Philly could be lost due to a drop in Medicaid enrollment and reimbursement revenue, according to city officials.
“Sadly, I think additional agencies are going to close,” Bailey said. “Our rates are going to be capped, our rates are going to diminish, and we’re going to have to make hard decisions, I think, about what the network looks like and who and how much we’re able to contract for.”
Philadelphia has contracted an independent consultant to work with city agencies on future Medicaid enrollment, community engagement, financial assessment and technology solutions in preparation of the federal policy changes, Solanke said.
Her department is also working with state leaders to figure out who may be exempted from Medicaid work requirements due to certain medical conditions and other factors. Federal guidelines are expected by June.
City agencies are looking to partner with schools, faith-based houses of worship, community centers and other locations throughout the city that can serve as places where people could seek help and support with Medicaid services and requirements.
“If we expand the places and the space people can go to for re-enrollment, I think it’s going to make a significant difference in terms of reducing the churn,” Solanke said.