Medicaid redeterminations began in April during the public health emergency, resulting in over 13 million disenrollments by year's end, primarily for procedural reasons. CMS is implementing measures to enhance transparency and automation in the eligibility and renewal process to minimize inappropriate disenrollments. Additionally, there is increased focus on social determinants of health, with CMS exploring models that integrate these factors and releasing a playbook to promote equity.

1. Redeterminations and Changing
Dynamics in Medicaid
Medicaid redeterminations started in April — when the
public health emergency (PHE) was still in effect. By
the end of the year, more than 13 million Medicaid
enrollees were disenrolled during these
redeterminations, with more than two-thirds getting
their coverage terminated for procedural reasons.
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2. CMS has taken substantive measures to
minimize inappropriate disenrollments,
including instructing states to evaluate not
only their redetermination metrics and
process, but also communication with
members. This foreshadows a shift towards
more transparency and automation in the
member eligibility and renewal process.
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3. Greater Emphasis on Social
Determinants of Health
(SDOH)
The past year saw a growing recognition of
the impact of SDOH on health outcomes, with
CMS taking the lead. CMS is exploring models
that integrate social health factors while
working around restrictions on certain groups
Medicare is allowed to pay. The agency also
issued its first-ever playbook to address
social determinants of health, which outlines
actions that stakeholders can take to
promote equity.
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