Millions May Lose Coverage, Access & Benefits to Behavioral Health Services When PHE Ends

Millions May Lose Coverage, Access & Benefits to Behavioral Health Services When PHE Ends

The COVID-19 Public Health Emergency (PHE) is set to end on April 11, 2023, potentially leaving an eye-watering 18 million people without health coverage. And this change will undoubtedly impact those who rely on behavioral health services for their well-being. During the pandemic, millions of vulnerable Americans gained access to behavioral health services due to the expanded Medicaid program. In addition, states were prohibited from disenrolling people in Medicaid for the PHE period. 

But with PHE ending, the people needing behavioral health services could see their coverage ending. Moreover, behavioral health practices face the taxing task of performing mass Medicaid eligibility checks on a scale never seen before. It's not all bad news, though - Robotic process automation (RPA) bots can help. 

What's The Impact On Behavioral Health?

Research shows that Medicaid coverage expansion positively impacts those with specific mental or behavioral health needs. For example, Medicaid eligibility expansion improves access to care and medication for adults with depression. It also increases the likelihood of being diagnosed with a mental health condition and using prescription medications to help ease the effects of specific needs. 

Moreover, improving access to care for people with severe mental or behavioral health illnesses can prevent costly interventions like criminal justice involvement or psychiatric hospitalizations later.

As a result, when the PHE is withdrawn in April, many millions of people may be left without access to behavioral health care and experience a decline in mental health.  

How Can Automation Help Redetermine Coverage? RPA to the Rescue

RPA excels at executing repetitive, mundane, and rules-based tasks typically performed by humans. And Medicaid eligibility and verification fit the bill perfectly.

Thoughtful is building a powerful bot that can check patients' Medicaid eligibility and verify coverage across various healthcare organizations, including behavioral health clinics and practices. This bot can execute a one-time check of all enrollees to ensure they meet the requirements for Medicaid coverage. With this information, behavioral health providers can get ahead of the situation and ensure they can meet their patient's needs without delay. This bot will also dramatically reduce the burden on behavioral health admin staff to conduct time-consuming and error-prone Medicaid eligibility checks at a time when the backlog will be more significant than ever before. 

In addition, existing RPA bots can perform much-needed checks for additional coverage. For example, bots may determine that patients can access the range they previously believed they were ineligible for. This allows behavioral health practices to better bridge the coverage gap and focuses on what matters most - providing excellent care. 

Lastly, automation through RPA can help reduce costly claims denials that harm the bottom line of behavioral health practices. Here, RPA bots can determine eligibility before a patient even arrives for their appointment. Bots can also ensure claims forms are free from error and contain the appropriate codes. 

Wrapping Up

Come April; behavioral health clinics face an administrative nightmare. They will have to begin re-verifying Medicaid eligibility for many patients, which is unmanageable without the help of automation. 

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Published On:

April 25, 2024

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