While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experiences across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.
Following up on the related session from the in-person SOA Health Meeting in June, 2023. Our panel will discuss the latest information available following the wind-down of the COVID-19 Public Health Emergency (PHE) and the phasing out the maintenance of effort (MOE) requirements, which resulted in continuous eligibility for Medicaid enrollees from the spring of 2020 through March of 2023, with a particular focus on issues impacting pricing and costs across each market segment. As Medicaid managed care programs across the country have adopted various approaches to these changes, we can begin measuring key indicators of experience against expectations that have been forecasted across stakeholders.
Specific topics of discussion are expected to include, but will not be limited to:
• How does the relative acuity of the individuals leaving/remaining/newly enrolling in each market segment compare?
• How does the volume and pace of enrollment increase or decrease compare to expectations?
• How are population demographics changing in each market segment?
• Has early emerging experience modified stakeholder expectations regarding the changes in the average acuity of their enrolled population and/or overall program costs in 2023 or 2024?
• How has the resumption of premium payments and/or cost sharing affected Medicaid beneficiary behavior?
Leave this session with new insights into the latest developments in the operationalization of the PHE unwinding, as well as how actuaries across each segment of the market are reflecting these enrollment changes in pricing exercises and forecasting cost and acuity changes in 2023 and 2024.