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Unwinding of Apple Health

During the COVID-19 public health emergency (PHE), the Health Care Authority (HCA) extended coverage for all Apple Health (Medicaid) clients. This extension ended on March 31, 2023 due to the Consolidated Appropriation Act, 2023. Jefferson Healthcare Patient Access team continues to work with patients to maintain coverage and help guide them through the billing process by answering insurance questions and answering financial counseling.

Unwinding of Apple Health
Featured Speaker:
Damon McCutcheon

As the Manager for Patient Access at Jefferson Healthcare Damon is responsible for overseeing patient registration and admission processes, insurance verification, and financial counseling services.

He manages the day-to-day activities of the Patient Access department and ensures that all patient registrations are processed accurately, efficiently, and in compliance with hospital policies and procedures. Damon also ensures that patient access services are provided in a timely and courteous manner and that patient satisfaction is maintained.

Transcription:
Unwinding of Apple Health

Prakash Chandran (Host): During the COVID-19 pandemic, clients of Apple Health, otherwise known as Medicaid, were given extended coverage by the Health Care Authority. Sadly, due to the Consolidated Appropriation Act, this extension ended March 31st of this year. Nevertheless, Jefferson Healthcare's patient access team remains committed to providing the financial information and counseling patients to ensure their coverage remains uninterrupted. Joining us today to discuss is Damon McCutcheon. He's the Manager of Patient Access and financial counseling at Jefferson Healthcare.


Host: This is To Your Health, a podcast brought to you by Jefferson Healthcare. I'm your host, Prakash Chandran. So Damon, thank you so much for being here today. I really appreciate your time. I wanted to get started by asking what exactly does the end of the Apple Health coverage extension mean for Medicaid clients in Jefferson County?


Damon McCutcheon: Yeah. So when the public health emergency first started, the Health Care Authority and Department of Social and Health Services relaxed the qualification requirements for Medicaid, really with the intent of more of our uninsured or underinsured population appropriate medical coverage. With that, now that we've seen that PHE come to an end, the original standards are being re-implemented and we're seeing a lot of those folks that had been eligible under the PHE requirements are going to no longer have their coverage as of this year. And so, Apple Health and the HCA is reaching out to these patients when they come up for their renewal process and letting them know that they may no longer qualify.


Host: So, I guess the question then becomes, what is Jefferson Healthcare doing to help Medicaid clients keep the coverage?


Damon McCutcheon: Absolutely. So, there's not much that we can do to help keep the coverage, but more help patients look at what their options are. So, initially, these Apple Health clients need to know that they're going to be losing their coverage. So, our teams are communicating with our Apple Health patients as we see them, making sure that they are verifying their contact information with HCA, so that they can actually get the notifications from them. Making sure that if they do start to receive these notifications, that they are actually reading them, following the prompts if they're digital messages, et cetera. And then, we also have resources here on site and locally that patients can go to if they have questions either on what their eligibility is and if there's anything that they can do or what other qualifying health plans may be out there that can provide comparable coverage for them.


Host: Yeah. So, really helping them evaluate what different options they have. But for those that need it, I am curious on whether Jefferson Healthcare supports patients who might be experiencing financial challenges.


Damon McCutcheon: Absolutely. We have a team of financial counselors here on site, all of them are certified application counselors with the HCA. So, not only are they able to either over the phone or in person work with our patients that come through the door that may have these financial concerns, we have a pretty robust financial aid process here, but being certified application counselors with the HCA, our team here can help sign patients up for new qualifying healthcare plans. We also have an HCA regional medical assistant specialist on site for eligibility questions as well.


Host: So, the financial assistance part is kind of what you were just covering, but I've also heard of something called Charity Care. Can you explain what that is and then also talk about the difference between financial assistance and Charity Care?


Damon McCutcheon: Absolutely. And they really blend together as far as I'm concerned. But we offer several different discounts for patients that may have either uninsured or have large balances due after their insurance does take care of things, whether that be PromptPay or something of that sort, where we're able to discount the total price that they owe. But also, if patients are meeting that financial criteria, we do have the ability to offer them, as you mentioned, the Charity Care program, which will write off a portion or all of their remaining balance, again, depending on their financial situation is.


Host: Okay. Understood.


Damon McCutcheon: And that's something that our financial counselors will work with on an individual level, each patient in each situation.


Host: So, you know, Damon, just as we begin to close here, this is a situation that can produce a lot of anxiety for people. And I know that Jefferson healthcare is there to support, but what is maybe a piece of advice or something that you want to leave with our audience just regarding this time and how you might support them?


Damon McCutcheon: Absolutely. That's a great question. Really, I'd like people to understand that we are here to help. The financial counseling team and patient access team here at Jefferson Healthcare is a tremendous resource. If people have questions about their existing coverage any pending changes to their coverage or are looking to see what options that they may have that would work better within the system, our financial counseling team is a tremendous resource to help walk through that process. And if we don't have the answers, we have quite a few options to refer folks out so that we can get them the best information possible so that they can make the decisions that will best facilitate their healthcare going forward.


Host: Well, fantastic, Damon. Thank you so much for your time today. I truly appreciate it.


Damon McCutcheon: Thank you.


Host: That was Damon McCutcheon. He's the Manager of Patient Access and Financial Counseling at Jefferson Healthcare. For more information about financial services and Medicaid, please visit jeffersonhealthcare.org/billpay. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. My name's Prakash Chandran. Until next time, stay well.