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March 29, 2023

MassHealth expanding call center ahead of eligibility redetermination

Photo | Courtesy of State House News Service Massachusetts Secretary of Health and Human Services Secretary Kate Walsh

With the state mired in a labor crunch, MassHealth hopes to double its call center workforce capacity in the next two months to deal with the undertaking of determining which of the 2.3 million people on the state-funded health plan are still eligible.

"No one who runs a call center is having an easy time staffing that call center right now," said Assistant Secretary for MassHealth Michael Levine. "It's a challenge, and it's one we're focused on."

An estimated 300,000 people are expected to lose MassHealth coverage over the next year as federal continuous coverage requirements for Medicaid in place since March 2020 expire and the state goes through a required determination process for the first time since the pandemic began, Levine said.

At a Joint Ways and Means Committee hearing on health care investments in Gov. Maura Healey's fiscal 2024 budget proposal, Levine said that the public insurance program is preparing for the onslaught of work checking the eligibility of those 2.3 million enrollees, and helping those who no longer qualify transition to other coverage.

They're ramping up their workforce across the board, Levine said, including doubling the amount of customer service representatives in call centers to 320, hiring an additional 100 workers to determine eligibility, 80 to 100 temporary employees to process applications, and using grants to scale up the certified application counselor workforce.

But across the state and the country public and private employers alike have been affected by a labor shortage in recent years. Massachusetts currently has 115,000 more job openings than unemployed workers, GBH reported last month.

Asked by Sen. Cindy Friedman how MassHealth will navigate hiring so many additional employees, some temporarily, with the ongoing labor shortage, Levine replied, "it's a question we think about every day."

"We are pulling out all the stops from ways of recruiting people, bringing them on and making sure it's a career path that they want to see," he said.

A MassHealth spokesperson did not immediately respond to an inquiry on how they would fund these new jobs.

The administration previously estimated that the number of members who are on MassHealth would drop from over 2.3 million to 1.9 million over the year of redeterminations. A MassHealth representative did not respond to a question on why Walsh and Levine said on Tuesday that 300,000 members would drop off, when they previously indicated it would be closer to 400,000.

"The numbers are projections, they're our best guess at this time," Administration and Finance Secretary Matthew Gorzkowicz said March 1.

After personal and professional challenges navigating the MassHealth system, Rep. Ann-Margaret Ferrante of Gloucester said she is worried that elderly and disabled people are going to have trouble navigating the redetermination process, regardless of the new hires.

An estimated 50 percent of MassHealth members will be automatically renewed. The other half will have to respond to a letter from MassHealth to prove their eligibility, and if they miss the letter they risk losing their coverage. Members will have 45 days to respond and if they fail to, they will then receive a letter informing them they have 14 days until they lose their coverage. After those who don't reply potentially lose coverage, there's a 90-day reconsideration period for them to return to MassHealth and prove eligibility to have their plan reinstated.

Eligibility redeterminations begin next month, and the program has 12 months to get through all 2.3 million people currently enrolled.

"I don't buy for a second that 150 people are going to help the situation," Ferrante said. "As someone who has a family member who's blind, happens to be my mother ... Please call her when she needs to fill out her redetermination paperwork. Mail is difficult because she's blind. And unless somebody accesses the mailbox for her and knows that something's coming, she may not get that piece of paperwork."

Levine said MassHealth is looking to make the application process easier and remain transparent throughout the redetermination process.

They cut the long MassHealth application by about 75 percent for applicants over 65 years old, Levine said, and next month they will begin allowing seniors to do their applications over the phone. These calls will take 90 to 120 minutes, "but it's a start" at making the process more accessible, he said.

Beginning in May, MassHealth officials will begin publishing a public dashboard that will show where the people who are losing MassHealth coverage live, their demographics, and the reasons behind lost coverage.

The redetermination process as a whole was top of mind for lawmakers, who had questions for Levine and Health and Human Services Secretary Kate Walsh.

Rep. Russell Holmes of Boston said he was concerned about MassHealth's IT system, after the state's unemployment insurance system was overwhelmed with claims when the COVID-19 pandemic took hold in March 2020. At the time, there was an eight-fold increase in the number of claimants from 20,000 in February 2020 to 160,000 claimants in March 2020 -- and many complained that the state's method for filing a claim, submitting documentation or following up on a request was outdated, clunky and frustrating to use.

The state's COVID-19 vaccine website also crashed shortly after it was rolled out. And the Health Connector had to revamp its insurance purchasing website in 2014 after its first attempt complicated the enrollment process for hundreds of thousands of residents, resulting in Gov. Deval Patrick's administration severing ties with the contractor that missed deadlines and delivered a faulty product, hiring new web developers, and racing to build a new site.

Holmes asked Walsh on Tuesday if MassHealth's system was ready to handle the influx of inquiries and new applications it is about to receive.

"The good news is, that we have been behind the scenes practicing, if you will, redetermination every month, and just not redetermining people off during the public health emergency," Walsh said. "So, I'm hopeful that the IT systems will hold."

Rep. Richard Haggerty of Woburn said during the flood of unemployment claims, legislators had weekly, then later monthly, meetings with former Gov. Charlie Baker's administration to tell them directly what they were hearing from their constituents.

"It allowed us to elevate issues, it wasn't long, it was probably an hour," he said. "But it gave us a direct link to the administration to be able to raise these issues with you all so that you can better service our constituents and our residents. So that's something I hope you'll consider with the chairs, or whoever it may be, to be able to coordinate that with the Legislature."

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