An examination of the redetermination situation

Following the end of the COVID-19 public health emergency this spring, states began the process of redetermining which residents are eligible for Medicaid coverage. New data shows that states are struggling with the administrative components of redetermination. As of last week, at least 5M Medicaid enrollees had been disenrolled, with 74% of those disenrollments related to procedural issues, and 35% of members reporting that they hadn't been contacted by their health plan to renew coverage for the next year.

There are major opportunities for digital health solutions to support the redetermination process by extending provider capacity, optimizing enrollee engagement, and supporting Medicaid data analytics. But digital health’s role in Medicaid expands beyond redetermination assistance—by improving access to lifesaving care, providing food-as-medicine, and making new drugs like GLP-1s accessible. There are no shortage of challenges in addressing such a complex space—but Medicaid is ripe for transformation.

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