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Spring has arrived, and I have just returned from the 23rd annual Hometown Health Spring Conference at Jekyll Island. This event consistently offers valuable interactions with healthcare providers. In addition to attending several sessions, I also manned the HCCS booth at the trade show.

Betsy Rios
HCCS Table
HCCS Table

A significant concern for providers that I learned about involves the end of the Public Health Emergency (PHE) and its implications for Medicaid. As the PHE comes to a close, Medicaid will undergo an unwinding process. Many beneficiaries currently receive Medicaid benefits due solely to the pandemic. Medicaid is now beginning to review all recipients to ensure they meet traditional eligibility criteria rather than the special criteria maintained throughout the PHE.

What does this mean for providers? In short, a considerable amount of work. The unwinding process will not occur all at once; the state of Georgia alone has stated it will take at least 11 months to "unwind" all Medicaid recipients. Providers will need to verify eligibility each time a patient visits until the process is complete. Many providers are identifying their Medicaid-covered patients and notifying them that they may need to reapply or risk losing their benefits. Consequently, a portion of these patients will transition back into the uninsured population, impacting providers' bottom lines and their ability to receive payment.

Another prominent topic at the conference was Medicare Advantage (MA) plans. Numerous providers expressed frustration with many current MA plans, citing difficulties in obtaining the necessary information to process their claims. Several have received denials for Medicare-covered services. It is worth noting that the Office of Inspector General (OIG) has recently been scrutinizing these plans. Representatives present at the conference mentioned that providers often do not utilize available online tools, such as policy documents, and may not be aware of what is traditionally covered by Medicare.

Jimmy Lewis, CEO of Home Town Health, delivered a talk during one of the town halls, emphasizing the importance of recognizing the vital role rural hospitals play in sustaining rural communities. Large businesses are unlikely to invest in a town lacking a hospital, and families are hesitant to relocate to areas without adequate school and hospital systems. Lewis also shared the story of his beginnings in rural health and the formation of Home Town Health.

Rural health is indeed the heartbeat of America, and as we transition into a new era (post-pandemic), these communities will face numerous challenges.


Topics: Spring Conference, Home Town Health, PHE, Medicaid, Medicare Advantage, MA plans, rural hospitals, rural health challenges

Betsy Rios, CPC

Written by Betsy Rios, CPC

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