News > Two United Hospital Fund Reports Address Interruptions in Medicaid Coverage

Even short gaps in Medicaid coverage can be problematic for beneficiaries, leading to a loss of primary care and preventive services, and to difficulty paying bills. Yet an estimated 46 percent of these low-income beneficiaries in New York are involuntarily disenrolled at some point in their Medicaid coverage, which also results in significant and unnecessary administrative costs for the state. Two new reports from the United Hospital Fund look at enrollment and renewal challenges and opportunities for children and for all long-term beneficiaries.

• Automated Renewal: Strategies to Maintain Coverage of Eligible Children in Medicaid and Child Health Plus analyzes the potential to enact continuous Medicaid coverage for children in New York State, where two million children are covered by public health insurance programs and 90 percent of the uninsured children are eligible. Written for the Fund by consultants at Manatt Health Solutions, this report reviews the necessary legal authority, recommended design, and potential barriers to implementation that such a plan would entail. This initiative would represent a transformative approach to reducing disruptions in care for children with public coverage.

• Coverage and Managed Care Enrollment Patterns among Long-Term Beneficiaries in New York's Medicaid Program examines the stability of Medicaid coverage and Medicaid managed care enrollment of adults and children in New York City over a four-year period, during which only 36 percent of the population had continuous coverage with a single type of enrollment (Medicaid managed care or fee for service). Written by Elizabeth Patchias, health policy analyst at the Fund, and Michael Birnbaum, director of policy for the Medicaid Institute at the Fund, this report quantifies coverage gaps and periods of unmanaged care, and considers the implications of such enrollment patterns for Medicaid policy.

“Interrupting coverage undermines all that good health care can accomplish, so solving this problem is fundamental to successful health reform,” says James R. Tallon, Jr., president of the United Hospital Fund. “These reports were written to advance discussions about how Medicaid, in a time of budget constraints, can more effectively and efficiently deliver health care to its beneficiaries.”

Both publications are available on the United Hospital Fund's website.

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.

About the Medicaid Institute™: The Medicaid Institute at United Hospital Fund provides information and analysis explaining New York's Medicaid program, with the goal of helping all stakeholders redesign, restructure, and rebuild the program.

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