One Person at a Time: Removing Barriers to Health Equity through Healthcare Coverage

As a trusted program partner to federal health agencies since 2013, Cognosante delivers critical healthcare information to the public through outreach efforts and contact center solutions rooted in innovation. Together with our customers, we have helped people enroll in health coverage, resolved enrollment coverage disputes, and provided operational and program support for federal and state healthcare programs.

In 2022, the federal government faced an unprecedented challenge with far-reaching impact – helping people maintain healthcare coverage when the COVID-19 Public Health Emergency and continuous Medicaid enrollment condition ended. That event – called the Medicaid Unwinding – represents the single largest healthcare coverage transition since the beginning of the Affordable Care Act. The law requires states to resume annual redetermination of consumers’ eligibility to continue Medicaid or the Children’s Health Insurance Program (CHIP). Those who lose coverage must find it through other sources, like the Federally Facilitated Marketplace.

To manage this transition, Cognosante was awarded the Enrollment Assistance Program (EAP) for Medicaid Unwinding contract by CMS to implement an EAP similar to one supported during the 2013 implementation of the Affordable Care Act. Through the EAP, our trained local support teams (called Assisters) work with local community organizations to reach out to those affected – low-income adults, seniors, families, and persons with disabilities – to help them find alternative coverage.

According to the Assisters, reaching out and building community knowledge is key. “Many of the people we speak to don’t know about Medicaid Unwinding,” says Denise Simpson, EAP Assister Supervisor in Shelby County, Tennessee. “Our community has a low literacy rate and people may not be aware of the changes that may impact their lives,” she says, “making in-person conversations critical.”

To build that awareness, her team uses a database provided by CMS called the Marketplace Assister Community tool to reach affected individuals. An Assister then places outbound calls and text messages, and teams hold community outreach events in libraries, community centers, and other public places, providing information on health plan options, and assisting with the application and enrollment process.

Now in its second year of operation, the EAP program is making a positive, life-changing difference for people across the nation. To date, Assisters have initiated more than 230,000 contacts to affected people, held 1,000 community events, and scheduled 1,800 appointments to assist consumers.

“This program is about much more than Medicaid Unwinding,” says Simpson. “It’s about sharing a variety of resources that affect people in the community. Every time we go to an event, people are so happy we’re there.”

Virginia Richardson, an EAP Assister Supervisor in Cook County, Illinois says, “Through the EAP, we’re meeting community and family needs that go beyond healthcare. When we contact consumers about their health coverage, we often end up providing resources for utilities, taxes, legal support, and even job training. One of our Assisters recently spoke to a Veteran who was living out of his car. The Assister enrolled him in healthcare coverage and provided referrals for housing and food stamps.”

Says Simpson, “What we’re doing is invaluable. I live in this community. My children are in this community. I believe in this project because I’m part of the community.”

Richardson agrees. “So many of the people we work with aren’t fully aware of their healthcare options, for different reasons. Often, they don’t know they’re losing coverage. It’s gratifying knowing we’re helping so many people – one person at a time.”

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