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New Medicaid community engagement requirements are approaching, and for health plans, preparation extends well beyond understanding the policy.
Under CMS’s current framework, certain Medicaid adults will be required to meet community engagement requirements or qualify for an exemption, with states generally required to implement the new requirements by January 1, 2027. When compliance cannot be verified, the process also includes member notification and an opportunity to respond.
But understanding the regulation is only part of the challenge. Health plans also need to consider what happens when policy reaches the member: Does the communication arrive? Is it understood? Does the member know what action to take? Can they complete that action? And does the organization have the processes in place to intervene when something breaks down?
Join Eric Levine and Michael Lutz of Avalere Health and Laura Massetti of Command Direct for a live panel discussion moderated by Desiree Vuocolo of the Managed Care Resource Alliance.
This panel will move from policy to practical execution, examining what health plans should understand now, where administrative and communication challenges can create barriers for members, and what organizations can begin putting in place ahead of implementation.
What They’ll Discuss:
- What the requirements mean for health plans and why preparation extends beyond regulatory compliance
- What previous implementation experiences can teach us about administrative friction
- Which members may require different levels of support
- What an effective member communication strategy looks like
- How plans should approach the member journey once the response window begins
- Who needs to own this work inside the health plan measuring success
- What health plans can begin doing now
This conversation will examine Medicaid community engagement requirements through the lens of member engagement, operational readiness, access, and meaningful member action.