Medicaid Redetermination: 5 Reasons Why Texting is Essential for Reaching Members Before It’s Too Late


The average person checks their phone 58 times a day, so there is a good chance that a text message will be read.

When the U.S. public health emergency created by COVID-19 eventually comes to an end, millions of Americans are at risk of losing their healthcare coverage. A recent study shows that 15 million people could lose health coverage by 2024 due to the expiration of two provisions that expanded access to coverage: the Medicaid continuous enrollment requirement and the American Rescue Plan Act of 2021, which made more people eligible to receive premium tax credits for buying insurance on the Affordable Care Act (ACA) exchanges.

The climate and tax bill that Sen. Joe Manchin has agreed to may extend the ACA premium subsidies. So, let’s focus on the Medicaid provision. Recertifying Medicaid members (aka redetermination) hasn’t been required since early 2020, so health plans have a lot of work ahead of them to ensure as many of the current 83 million Medicaid and CHIP enrollees remain covered. This is no easy task. It will require health plans to get creative in how they communicate, connect and engage with their members.

An easy and effective way to engage with members is through text messaging campaigns. Texting in healthcare is an extremely powerful – yet often underutilized – communication tool, and something Medicaid plans should consider doing more of in the coming months.

Clearly, texting has become ubiquitous. In 2021, Pew Research reported that 97% of American adults own a cell phone of some kind, regardless of socioeconomic status.

Beyond that, here are five reasons why texting campaigns should be essential components of any communications campaign for Medicaid redetermination:

1. Manageable regulatory risk

No one wants to receive unsolicited text messages, or “spam texts.” But when done correctly this type of texting shouldn’t fall into that category. Multiple exemptions cover healthcare messages, including a conditional exemption for messaging from healthcare providers that have obtained prior consent and an exemption for immediate exigent healthcare messages, such as recertification deadlines. In addition, in 2021 the Supreme Court ruled that Facebook did not violate the Telephone Consumer Protection Act when it used automated text messages to send security alerts to a targeted list of consumers’ cell phones. This ruling cleared the way for organizations to more freely share automated messages to reach targeted consumers. Targeting and contacting Medicaid members is fully within the scope of this ruling, allowing health plans to provide crucial information via texting to members at a moment’s notice so they do not lose their coverage.

2. Action oriented

Text campaigns can conveniently and effectively communicate a call to action to members. Ninety-five percent of text messages are read within three minutes. Text messages can include links or phone numbers that can direct members to additional information, resources, or a platform that can help them navigate health benefits and drive action.

For Medicaid redetermination, the calls to action can be as simple as notifying members of upcoming deadlines, providing a link or instructions to update their contact information or giving them a phone number to call if they have any questions. Thiscould be the first part of a larger multi-channel campaign to educate members on Medicaid redetermination, help them understand why they need to take steps to retain their eligibility, and connect them to support.

3. Engaging and referred

Cell phones are an essential part of most people’s daily lives. With the average person checking their phone 58 times a day, the likelihood of a text message being seen in a timely manner is high.

Many people also prefer this form of communication. Texting has been shown to be an especially effective way to communicate with patients during the COVID-19 pandemic. According to a 2021 study, 85% of patients preferred text updates compared to email, phone calls or patient portal messages. A text message is quick and easy to read at a person’s convenience, unlike phone calls, which can be lengthy and ill-timed. Receiving communications via text also allows members to keep and refer to past text alerts in case they forgot the message or need to pass it along to a family member. While phone calls are a fundamental part of many communications campaigns, text messaging offers additional and unique opportunities to reach and engage members in ways that traditional phone calls may not.

4. Health equitable

Low-income members may struggle with housing insecurity, making traditional mail communications difficult if their address changes. Fortunately, cell phone numbers don’t change as frequently since they can be ported, giving health plans an easy and reliable way to stay in contact with members. Wireless local number portability has been widely available in the U.S. since 2004, and most Americans who switch providers are able to retain their phone number.

The Centers for Disease Control and Prevention also found that a majority of households in poverty are cell phone-only homes, which means contacting members exclusively via landline phone calls is not an effective outreach strategy. To successfully reach and support all members, equitability needs to be considered when selecting communication channels for important and time-sensitive information. Integrating text messaging into multi-channel communication campaigns can allow for broader reach among members.

5. Cost effective

Traditional direct mail is still a necessary part of campaigns when hard-copy paperwork must be completed. This may be applicable for Medicaid redetermination in some U.S. states where the actual certification needs to be manually completed and mailed. However, text messaging is an effective and cost-effective communications medium. Direct mail requires printing and shipping budget, and sometimes a mailer may not even reach the intended recipients if they moved or if the sender had inaccurate or outdated address information. Email campaigns are cost effective but are not as successful as text campaigns. The average open rate for a text campaign is 98% whereas for email it is significantly lower, at just 20%. While all of these channels play an important part in a communications campaign, text messaging is a great way to engage the hard-to-reach, and to share important information and reminders about taking timely action.

Texting has uses in healthcare beyond Medicaid redetermination and with significant changes to Medicaid eligibility on the horizon, its importance as an effective member engagement tool cannot be understated. Texting has previously been shown as a successful way to engage communities in vaccinations, quickly share public health information, send appointment reminders and even drive medication adherence.

Regardless of socioeconomic or housing status, most Americans have a cell phone. Reaching and engaging underserved populations has historically been challenging. Managed care organizations should absolutely consider utilizing text messaging as part of comprehensive, multi-channel healthcare communication campaigns. It is through this simple, efficient, and cost-effective medium that we have the potential to help people across the U.S. retain their much-needed health coverage.

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