Nov 23, 2020
Pandemic-Driven Medicaid and ACA Expansion
Impacts and Considerations for Payers
By Jimmy Liu and Dan O’Brien
Jimmy Liu is vice president of Risk Analytics at Change Healthcare. Dan O’Brien is director for Risk Adjustment Strategy at Change Healthcare.
Understanding the full impact of the COVID-19 pandemic on the healthcare industry is not yet possible, but a few outcomes are evident. Medicaid and Affordable Care Act (ACA) enrollment rates are surging alongside the unemployment rate. In addition, postponed procedures and delayed routine services—as well as pent-up demand for elective procedures—will soon drive increased utilization.
This report details expected changes in the composition of national Medicaid and ACA member populations, and explores the potential financial consequences of the pandemic on payers. We address the timing of the Medicaid/ACA expansion and provide five immediate, actionable strategies to help payers mitigate challenges caused by the pandemic.