Unwind Reporting Frequently Asked Questions
When will reports be posted?
HCPF will be publishing data monthly after it has been submitted to the federal government. We will post reports on the Continuous Coverage Unwind Data Reporting page and include links to this information in our monthly COVID-19 Public Health Emergency Updates newsletter. To sign up for the newsletter, see our newsletter sign-up page and select the COVID-19 newsletter.
This data is available monthly. Can we get the data more frequently?
It is critically important to share accurate information with the public, including our federal and stakeholder partners. HCPF does not have resources to pull ongoing ad hoc reports which also risk inaccuracies and public confusion if the numbers are different given different point in time data pulls.
Can we get more detailed information? Is county level data available?
Yes, HCPF will be sharing demographic and regional data breakouts in our quarterly partner webinars. This will be a deeper dive than the information provided in the federal monthly reports. Looking at this information quarterly will allow us to spot any trends and share those out with community partners.
For stakeholders interested in enrollment changes by county, we currently have county level Health First Colorado (Colorado’s Medicaid program) and CHP+ enrollment data available on our website in existing monthly caseload reports. These reports are published mid-month and include enrollment information for the prior month. The caseload reports are a point in time and include historical months.
What is a procedural denial?
A procedural denial is a denial of health care coverage because a proper eligibility determination could not be made. Examples include: someone not returning the renewal packet, not signing the signature page of the renewal packet, incomplete information/verifications not provided or could not contact the member/whereabouts unknown.
How does the PHE unwinding data compare to Health First Colorado redetermination data before the pandemic?
Leaving Health First Colorado or CHP+ coverage during the renewal process is part of normal eligibility operations. Renewals conducted pre-pandemic resulted in an average of 41% of Medicaid members losing coverage annually for procedural reasons (12%) and eligibility reasons (29%).
As we return to normal renewal processes, we anticipate a similar percentage of individuals will leave the program. Individuals can reapply for coverage at any time and could rejoin the program when they qualify. Based on pre-pandemic information, on average, about half of the members who had lost eligibility were deemed eligible for Medicaid again within two years.
For those that no longer qualify for Health First Colorado or Child Health Plan Plus (CHP+), do you have a way of tracking if they have other health care coverage or if they are uninsured?
We anticipate many enrolled in Health First Colorado who are no longer eligible will already have other coverage through an employer, Medicare or other source. Those who do not will need to be connected to other health care coverage.
We will be tracking who is enrolled in Health First Colorado and CHP+ and publishing enrollment information monthly. There is not a centralized statewide database to provide a clear metric to see how many people lose Medicaid coverage and transition to other forms of coverage or go uninsured as a result. Further complexity is added because former Health First Colorado and CHP+ members have up to a year to enroll in a marketplace plan due to an extended Special Enrollment Period. The time frame for this Special Enrollment Period is from April 1, 2023, through July 31, 2024. So, a member may lose coverage and find alternate coverage within a month or up to a year.
Connect for Health Colorado will be reporting the number of individuals who no longer qualify for Health First Colorado or CHP+ that qualify and enroll in their plans. The federal government plans to publish information in the fall of 2023 on transitions in coverage, including information about those who were up for renewal that are now covered by Medicare.
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