How SMS Can Play a Vital Role in Medicaid Unwinding Awareness


As the country and world move into a post-COVID world, many governments find themselves dealing with transitions away from policies created to provide assistance during the pandemic. One such change currently impacting both federal and state governments is Medicaid Unwinding.

Early in the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which provided guidelines for federal Medicaid funding. In order to receive funding, Medicaid programs were required to keep people continuously enrolled through the end of the COVID-19 public health emergency. After passage of the Consolidated Appropriations Act, 2023, signed into law in December 2022, Congress has set an end date of March 31, 2023 for the continuous enrollment provision, with enhanced federal Medicaid matching funds winding down through December 2023.

FFCRA sparked a significant increase in Medicaid enrollment and saw a drop in the overall uninsured rate. Now, even with certain reporting and other requirements in place during the unwinding process, states face a challenge to increase awareness. The Center for Medicare Services (CMS) has highlighted the four areas where states face the greatest challenges in Medicaid and the Children’s Health Insurance Plans (CHIP): renewals and redeterminations, updating enrolling contact information, workforce capacity, outreach, partnerships, and communication.

In dealing with all these challenges, states are looking for communications strategies that both raises awareness and encourages quick and timely action to be taken by communities that are frequently low-education, low-technology, and non-English speaking. In a recent webinar, titled “Expert Strategies to Leverage Technology and Data for Medicaid Unwinding,” the role of SMS and text messaging was discussed as one way to create improved connection, communication, and action.

Understanding the Challenges

The immediate impact of Medicaid Unwinding is an obvious one: Millions of individuals and families who enrolled in Medicaid or CHIP programs will no longer have benefits through their plans unless they re-enroll. Raising awareness of changes while also encouraging action to re-enroll for coverage goes beyond the typical communications plan, according to webinar panelist Angy Peterson, Vice President, Granicus Experience Group.

“It quickly progresses into more of an educational style communication,” she said. “There’s perhaps multiple messages that go out explaining the process that plan members are going to have to go through, giving them that proactive education that ultimately builds that confidence that they have what they need to complete enrollment.”

That education goes beyond the enrollment process, itself, she added, to include education on the value of Medicaid benefits, as well. Raising awareness and understanding of how not participating is also an important are for communication as well, helping enrollees understand the impact they and their families will face by not re-enrolling.

With a great deal of information to be shared and action required in so short a time, communicators may feel that they must deliver a large amount of content to audiences as quickly as possible. But panelist Perla Ni, CEO, CommunityConnect Labs, warned against giving audiences too much information to review, instead suggesting authentic and personal messaging.
“This is a low-literacy population,” Ni said. “They don’t want to read through a wall of text on how to go through a process.”

How SMS and Text Messaging Addresses Barriers

Just as the COVID pandemic created the policies that Medicaid Unwinding is now rolling back, communications strategies and tools learned to deal with the pandemic provides ways to overcome some of the barriers now faced.

During the COVID pandemic, two-way SMS messaging provided personal messaging to a wide variety of audiences, including those who did not have access to a computer or desktop internet. Vaccination awareness outreach delivered to cell phones not only helped inform about vaccination availability but provided a direct way for audiences to act, signing up for appointments in their area.

The impact of SMS messaging has continued post-pandemic. Granicus data shows that audiences who receive very segmented and specific messaging are 38% more likely to take desired action online and 60% more likely to complete an account login. SMS follow-ups can increase completion rate by 15%.

The example of vaccination messaging, Ni said, offers a blueprint for Unwinding strategies to build effective SMS messaging tactics.

“Not only were you telling people how and where to get vaccinated, but you were asking them a question to engage them,” she said.

Just as with questions regarding vaccine status that encouraged two-way engagement, SMS messaging can integrate a similar approach to gathering information on enrollment status. As an example, Ni suggested, a message reminding a person that they need to re-enroll for Medicaid can an automated eligibility quiz via a chatbot to verify program eligibility and offer next steps.

“This has two benefits,” Ni said. “One, it gives you data that stops outreach to people who say they have started the enrollment process. Two, it helps people engage with the subsequent messages. They’re not going to ignore it. When people respond to that initial message and answer your question, they are invested in what you have to say.”

As with all data, more information allows for more audience segmentation that can be useful in future related outreach efforts as long as communicators continue to put value into that data. Many states currently implement SMS messaging for an array of time-sensitive campaigns, leveraging data from previous efforts to improve outcomes.

“You can have that engagement, you can have that almost dialogue, but the key is to then continue,” said Peterson. “This is a way to build a new foundation for a new way to be communicating with Medicaid enrollees and beneficiaries long term beyond this pressing moment right now. The next time that there is a big change to eligibility requirements or timing, you already have that relationship established and those ways of communicating with them established so that you can quickly execute against those next new changing timelines or requirements.”

Implementing SMS Outreach to Existing Strategies

For agencies working to better engage with enrollees impacted by Medicaid Unwinding, SMS and text messaging presents a direct, personalized tactic that brings valuable data while moving the needle on program outcomes. Digital tools, such as Granicus’ govDelivery, can easily help communicators implement SMS messaging and engagement.

Ready to learn more strategies for informing and engaging audiences impacted by Medicaid Unwinding? Talk to our team.

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