News > United Hospital Fund Releases Report That Finds Streamlining Public Insurance Renewal Holds Promise for New York

The United Hospital Fund has released a report that examines lessons from eight other states regarding options to streamline the annual renewal process for beneficiaries of public health insurance. The findings strongly suggest that a combination of these options may work well for New York in maximizing retention of enrollees and reducing per-beneficiary administrative costs to the state, with little risk to program integrity.

Many experts agree that achieving universal health insurance coverage in New York will be impossible without first addressing the problem known as “churning,” the involuntary disenrollment of beneficiaries largely because of burdensome renewal requirements that go unmet. One study has shown that 46 percent of New York's Medicaid and Family Health Plus recipients are involuntarily disenrolled at renewal, while another has shown that 60 percent of those leaving the Child Health Plus rolls have failed to complete the renewal process.

The report—“Streamlining Renewal in Medicaid and SCHIP: Strategies from Other States and Lessons for New York”—concludes that a single approach to streamlining may not work for all beneficiaries of all public programs, partly because enrollees in the public programs are not subject to the same eligibility and proof requirements, and partly because individual circumstances related to literacy, residence, income, and stability vary. The report found merit in each of the four different renewal processes it examined: administrative, ex parte (e.g., coordinating information with a Food Stamps program), rolling, and telephone renewals. It provides examples from different states of the effects of implementing, or of ending, simplified renewal, including the impact on renewal rates and administrative costs.

The increased burden that states face as a result of the new federal Payment Error Rate Measurement (PERM) program, which requires more exacting verification of eligibility for a subset of Medicaid and SCHIP beneficiaries every three years, is also discussed. Officials in states whose programs have already been subject to such audits find that the PERM burdens and risks can be managed in the context of a streamlined renewal process.

“This report gives further support for New York's ongoing efforts to determine the most effective ways to streamline the public program renewal process,” said James R. Tallon, Jr., president of the United Hospital Fund. “Understanding the successes and challenges faced by other states can only help New York in making informed decisions. The end result will be improved continuity of care for some of our state's poorest residents and a reduction in wasted time, effort, and administrative costs associated with losing an enormous number of qualified beneficiaries at renewal time.”

The states whose renewal programs were examined for this report include California, Florida, Illinois, Georgia, Louisiana, Arkansas, Utah, and Hawaii.

Streamlining Renewal in Medicaid and SCHIP: Strategies from Other States and Lessons for New York is available on-line. The report was prepared for the Fund by colleagues at Manatt Health Solutions, and was undertaken with support from the United Hospital Fund, the Children's Defense Fund-New York, and the New York State Coalition of Prepaid Health Services Plans.


About the United Hospital Fund: The United Hospital Fund is a health services research and philanthropic organization whose mission is to shape positive change in health care for the people of New York.


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