Now is the time to modernize communication in Medicaid – Healthcare Blog
TV Show 60 Minutes, Roseanne, What do women have in common with murders? According to Nielson Media Research, they were the top 10 prime time periods in 1991-92 seasons. Obviously, the situation Americans want to watch has changed for 34 years. Major networks with declining market share (ABC, CBS and NBC) have experienced the dramatic growth in streaming services proved this. It makes sense to have people watch what they want to watch on the device of choice and use new technologies such as streaming services to access the shows they want to watch. It would be foolish for us to insist that Americans only watch traditional network shows on traditional TV. But that's basically what we're doing now, when we forced the Medicaid-managed Care Program (Plan) to communicate with 1991 federal laws with Medicaid recipients.
This is the problem. Federal legislation says the Telephone Consumer Protection Act (TCPA) was enacted in 1991, making it difficult for states and programs to communicate with their members using text messaging, even if texting is the primary form of communication for all Americans, including Medicaid recipients. TCPA requires that the status or plan of the text be obtained before sending it to obtain permission from the person receiving the text. Violations of TCPA can result in serious financial fines for each violation, and if the sender intends to send text without the consent, the sender will be fined three times.
Medicaid recipients are usually assigned to programs, and they do not choose programs, so given the TCPA and potentially assessing the huge financial penalty, programs are already on the standpoint that they do not accept the recipient's consent to text them. This is the problem.
Sending texts is the way most Americans communicate today. Other modes and other methods (for example, there are reasons to be called snail mail), phone calls (who answered the call?) and emails (maybe there are no responses in a few days or weeks). Because they are low-income, many Medicaid recipients usually don’t have landlines or laptops. They rely on their cell phones for all communication, including those related to healthcare. Sending text is their first choice, and is usually the only way to communicate.
As Founder and CEO of Samesky Health, I spent more than a decade working with programs to help them engage members and navigate to healthcare at the right time and in the right place. Time and again we have found that when we can impose outdated program restrictions on TCPA, we gained higher engagement, which translates into better childhood visits, more breast cancer screening, more diabetes (A1C) screening, and more. Using modern communication tools is a way to meet people. It builds trust and leads to better health outcomes. But sadly, we are unable to text messages in most cases due to TCPA.
This is a major issue that will make exponential-level issues worse when federal job requirements are implemented. The requirements for federal Medicaid work will greatly increase the need for modern countries and programs to communicate with Medicaid recipients. Compliance with TCPA is hindering this modernization. And, if there is no fixed, there are many people who will lose Medicaid benefits for purely procedural reasons.
To improve health outcomes, allow effective communication to verify work status, and provide two annual re-determination information, the state and program must exempt TCPA from outdated regulations. The final passage of settlement legislation adopted by the Senate provides the best opportunity for obtaining TCPA exemptions and signing the law.
Now is the time to act.
So let's focus on (1) getting the language of exemption in the Senate version of settlement legislation, (2) working with HHS and CMS to ensure legislation guides the state and plans to make text messages best practices when implementing the work requirements program and communicating with recipients more generally, and (3) implementing more effective technologies to build new technologies to build new technologies to build new technologies to take into account new technologies.
We have two months (June and July) to act for the Senate exemption and for the rest of the year to influence government guidance on the work requirements plan.
If we succeed, Medicaid beneficiaries will be the biggest winners, as exemptions are a key strategy to reduce unnecessary Medicaid benefits losses.
What can you do? Call your senator and ask them to support how modern nations and programs communicate with Medicaid recipients. And please share this blog post with your network.
