This brief focuses on states’ experiences in implementing data-driven renewals in Medicaid through a process called ‘ex parte’ – using third party data sources to confirm ongoing eligibility. We interviewed officials in eight diverse states to identify the challenges states face in automating the renewal process and summarize their experiences in overcoming these barriers to achieve high rates of ex parte renewals. The authors also drew on their deep knowledge about the state processes and input from stakeholders who are familiar with the federal rules and have first-hand experience with how implementation of data-driven renewals is playing out in the states.
Leading states have shown that it is possible to renew coverage for the majority of Medicaid enrollees through automated processes. High rates of automated renewals contribute to greater administrative efficiencies, increased retention of eligible individuals, and fewer gaps in coverage and access to care. Importantly, promoting retention and eliminating gaps in coverage and disruptions in care may lead to better health outcomes and enhance a state’s ability to measure the quality of health care for children and adults in Medicaid.
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