Department of Medicaid
Ohio's eligibility operations data update presented by Samantha Howe, PhD, PMP on November 16, 2023, includes information on renewal due dates, CMS required reporting, call center data, PHE applications, and renewal outcomes. The report highlights the significant progress made in renewing recipients, handling call center volumes, processing applications, and achieving successful renewal outcomes.
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Ohios Return to Routine Eligibility Operations Data Update Presented by Samantha Howe, PhD, PMP November 16, 2023 MCAC
KEY NOTES & DATES April 2023 was the first month of renewal due dates that states were permitted to begin routine eligibility determinations Ohio s ex parte (aka passive renewal) runs two months prior to due dates To date, the renewals for 1.8 million recipients have been initiated. 3
CMS REQUIRED REPORTING Monthly Performance Indicator Reporting has been required since 2016 Includes Call Center, Applications, Caseload, Account Transfers, and Determinations data Unwinding Specific Reporting Baseline report on Caseload and number of Pending applications received during the PHE Monthly cohort reporting on renewal outcomes Due on the 8th of each month Initial technical guidance from CMS defined cohorts as those who were initiated through ex parte review in the corresponding month As of July 2023, additional guidance respecified the cohort definition to be based on the corresponding due date regardless of method of renewal initiation 4
CMS REQUIRED REPORTING: CALL CENTER DATA 300000 7:12 Has handled over 1.5M phone calls since the start of Unwinding activity Average wait time of less than 5 minutes Average abandonment rate of 5% 250000 6:00 200000 4:48 150000 3:36 100000 2:24 50000 1:12 0 0:00 Mar-23 Apr-23 May-23 Jun-23 Jul-23 Aug-23 Sep-23 Oct-23 1. Total Call Center Volume 2. Average Call Center Wait Time 5
CMS REQUIRED REPORTING: PHE APPLICATIONS 46,684 applications were received during the PHE and pending at the start of Unwinding As of 10/31/23, 99.9% of applications have been completed Of the 53 still pending, 43 (81%) have had an initial determination Completion of PHE-era Applications 0 5000 10000 15000 20000 25000 30000 35000 40000 45000 50000 February March April May June July August September October Still Pending 6
CMS REQUIRED REPORTING: RENEWAL OUTCOMES 350,000 On average, nearly 70% of recipients up for renewal in a given month are renewed successfully Approximately 15% of people up for renewal in Ohio are discontinued due to procedural reasons Approximately 9% of individuals up for renewal do not receive an initial decision by their original due date (are pending) 300,000 250,000 200,000 150,000 100,000 50,000 0 Apr 2023 May 2023 Jun 2023 Jul 2023 Aug 2023 Sept 2023 Oct 2023 Renewed passively Renewed manually Terminated - Ineligible Terminated - Procedural Redetermination Pending 7
CMS REQUIRED REPORTING: RENEWAL OUTCOMES Apr 2023 May 2023 Jun 2023 Jul 2023 Aug 2023 Sept 2023 Oct 2023 Classification Short Description n % n % n % n % n % n % n % CMS_5A1 Renewed passively 104,872 37% 121,124 38% 115,986 36% 128,489 40% 133,566 45% 138,895 47% 139,747 47% CMS_5A2 Renewed manually 104,965 37% 110,662 35% 100,097 31% 88,212 28% 59,591 20% 55,765 19% 56,424 19% CMS_5B Terminated - Ineligible 21,284 8% 23,064 7% 18,990 6% 17,383 5% 16,972 6% 16,297 5% 18,585 6% CMS_5C Terminated - Procedural 46,707 16% 49,367 16% 55,666 17% 61,123 19% 59,378 20% 57,292 19% 52,782 18% CMS_5D Redetermination Pending 5,609 2% 11,814 4% 27,574 9% 24,861 8% 24,071 8% 29,278 10% 30,620 10% Total Reported 283,437 100% 316,031 100% 318,313 100% 320,068 100% 293,578 100% 297,527 100% 298,158 100% https://medicaid.ohio.gov/stakeholders-and-partners/covidunwinding/covidunwinding 8
PEER STATE COMPARISON Aug-23 3% 31% 12% 12% 42% PA Sep-23 OH 47% 19% 19% 5% 10% Sep-23 79% 0% 18% 2% 0% NC Aug-23 31% 36% 28% 5% 0% MI Sep-23 45% 9% 1% 10% 36% KY Oct-23 39% 11% 21% 3% 25% IN Aug-23 40% 18% 1% 5% 36% IL 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Renewed Ex Parte Manual Renewal Procedural Termination Ineligible Pending 10
COUNTY PERFORMANCE & MONITORING Activity Dashboard: https://medicaid.ohio.gov/stakeholders-and- partners/covidunwinding/stakeholders/cdjfs-dashboard/cdjfs- dashboard As reflected on the Benchmark view, for the most part, counties have been able to complete at least 90% of the manual renewals that are due in each month 11
FORECASTS To date, disenrollments have been slightly higher than initial projections However, caseload estimates account for those who return to or newly join Medicaid through new applications or by returning their renewal packet late We are just now able to begin to assess the first month s renewal churn patterns and net impacts Churn appears consistent with recent historical patterns and thus we expect the trend over time to end up looking similar to initial projections 12
QUESTIONS? medicaid.ohio.gov
