Engaging with Medicaid members is becoming increasingly complex yet essential, especially following the passage of the One Big Beautiful Bill Act (OBBA). Rhonda Aubrey, Co-Founder and Vice President of Programs at Beheld, emphasizes that addressing the diverse barriers faced by these individuals is crucial for fostering meaningful connections and enhancing overall healthcare experiences.
Medicaid was established in the 1960s to provide essential healthcare to vulnerable populations, including low-income families, pregnant women, and people with disabilities. Over the decades, the program has evolved, yet many misconceptions persist regarding who it serves and how individuals should navigate its often complicated structure. As healthcare is managed at the state level with varying rules, experiences can differ widely, even among individuals with similar circumstances.
Recent findings from a Kaiser Family Foundation poll indicate that approximately 56% of Americans mistakenly believe that most working-age individuals on Medicaid are unemployed. In reality, nearly two-thirds of these adults are employed, while others are unable to work due to qualifying exemptions such as illness, disability, or caregiving responsibilities.
Understanding the Impact of Medicaid’s Challenges
The introduction of the OBBA this past summer is expected to significantly transform the Medicaid landscape, with estimates suggesting that nearly 12 million people may lose their health insurance by 2034. This legislation has sparked industry discussions on how best to support this vulnerable population, often without direct communication with Medicaid members themselves.
Aubrey notes from her experience managing a network of Federally Qualified Health Centers (FQHCs) in the San Francisco East Bay that Medicaid members are frequently viewed through a lens of stereotypes that can hinder effective outreach. These individuals are often unfairly characterized by notions of laziness or entitlement, overshadowing their legitimate needs and the complexities they face in accessing care.
The Medicaid system suffers from structural inefficiencies that directly affect member engagement. High enrollment churn is common, as eligibility can shift based on income and family circumstances. The administrative burdens imposed by the redetermination process can lead to members losing coverage, disrupting continuity in care and forcing them to switch providers frequently.
Strategies for Effective Member Engagement
To improve member engagement, it is vital for healthcare providers to develop approaches that resonate with Medicaid members and meet them where they are. Building trust through consistent, empathetic communication is crucial. Research has shown that empathy-based interventions, such as regular phone calls from trained non-medical staff, can lead to significant improvements in both mental and physical health outcomes for patients, including those with chronic conditions like diabetes.
Creating meaningful connections with members is essential. The challenges of the digital divide, language barriers, and cultural differences complicate outreach efforts. Yet, the importance of connection cannot be overstated; genuine concern from care teams can significantly enhance a member’s health experience.
Furthermore, labeling members as “non-compliant” can alienate them, reinforcing feelings of disenfranchisement. By demonstrating compassion and understanding of the daily struggles faced by Medicaid members, healthcare providers can foster an environment where members feel validated and empowered to engage in their care.
The modern Medicaid experience is often fragmented, but through empathetic listening and outreach, healthcare systems can begin to mend the disconnect between providers and the populations they serve. A more human-centric approach to Medicaid member engagement has the potential to improve retention rates, health outcomes, and overall satisfaction, ultimately benefiting all stakeholders involved.
Rhonda Aubrey, with over three decades of experience in healthcare operations and innovation, emphasizes the need for a compassionate, evidence-informed approach in Medicaid programs. As the healthcare landscape evolves, understanding and addressing the real needs of Medicaid members will be critical for creating a more equitable and effective healthcare system.
