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  • Focus on Medicaid Eligibility Renewals

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    Posted December 8, 2023
    By Aditi Mallick, M.D.
    Acting Director, Centers for Medicare & Medicaid Services, Office of Minority Health


    Earlier this year, state Medicaid and the Children’s Health Insurance Program (CHIP) began the process of conducting renewals for health care coverage, following the end of the COVID-19 public health emergency. While many individuals and families who are no longer eligible for Medicaid or CHIP have or will transition to other forms of coverage during this process, many people are at risk of becoming uninsured and having a harder time accessing critical health services.

    The Centers for Medicare & Medicaid Services (CMS) is committed to connecting with underserved communities that are medically underserved so that they have the resources needed to determine if they or a family member will still qualify for Medicaid and CHIP, or an alternate form of coverage, such as through HealthCare.gov.

    What Happens During Medicaid Renewals
    Medicaid and CHIP renewals are a multi-step process, and states must begin the process by attempting to complete renewal of coverage based on information available to them without contacting the individual. If that is not possible, agencies must send renewal notices and requests for information to enrollees.

    Many individuals enrolled in Medicaid may have moved during the pandemic and may not receive renewal notices at their new addresses. Others may receive notices but may not know that Medicaid renewals have restarted, or they may face barriers as they take steps to complete renewals. These challenges may lead individuals to be disenrolled from Medicaid or CHIP, even if they are still eligible, leading them to lose access to necessary health care services and medications, or their health care coverage may be interrupted or discontinued.

    While each state is approaching Medicaid and CHIP renewals differently, racial and ethnic minority communities that are underserved are likely to be disproportionately impacted. Medicaid and CHIP disproportionately provide coverage to individuals and families from racial and ethnic minority communities and people living in rural areas. Higher rates of homelessness or language barriers may further impede the ability of these communities to receive or understand renewal notices crucial to ensuring continuity of coverage.

    Medicaid Renewals 101
    In March 2020, as part of COVID-19 relief, Congress authorized additional Medicaid funding for states on the condition that they satisfied a “continuous enrollment” condition, which generally prohibited states from terminating most Medicaid enrollees’ enrollment until the end of the COVID-19 public health emergency. This helped to ensure millions of people could remain enrolled in Medicaid coverage without interruption during the pandemic. The continuous enrollment condition ended on March 31, 2023, allowing states to begin to return to normal operations around eligibility and enrollment, including conducting Medicaid renewals, beginning on April 1, 2023.

    States have independent obligations under federal civil rights laws to ensure that individuals and families continue to have access to Medicaid and CHIP, as states conduct renewals. For example, states are required to take reasonable steps to provide meaningful language access for individuals with limited English proficiency and ensure effective communication with individuals with disabilities. Ensuring access to information is vital and required.

    Know Who is Affected
    Millions of people could be disenrolled from Medicaid and CHIP during this renewals process, with people from racial and ethnic minority communities at higher risk. Children and young adults, as well as Latino and Black individuals, are predicted to be disproportionately impacted. Seamless transitions to other forms of coverage, such as through HealthCare.gov, will play an important role for many in maintaining coverage for those who are no longer eligible for Medicaid and CHIP coverage.

    Nearly one-third of those predicted to be disenrolled from Medicaid are Latino individuals (4.6 million) and 15% (2.2 million) are Black individuals. As the single largest payer for mental health services in the United States, Medicaid is critical in the treatment and success of those with mental illness. With health care coverage, mental health patients have access to ongoing treatment, medicines, and care that help keep them out of hospitals, emergency rooms, and the cycle of chronic homelessness. Furthermore, individuals with serious mental illness often have co-morbid physical health conditions and substance use disorders, making continuous health care coverage even more critical.

    Know How to Help
    Without health coverage, people from racial and ethnic minority communities and other populations that are underserved could see a lapse in the progress they were able to make during the pandemic when Medicaid enrollment was continuous. Information on the Renew Your Medicaid or CHIP Coverage webpage is a great starting point for helping people better navigate Medicaid and CHIP renewals. The webpage outlines how to get ready for the renewal process, what to do if you no longer qualify for Medicaid or CHIP, and where to go for more help, including how to contact each state’s Medicaid office. Find toolkits, drop-ins, creative assets, and translations on the Medicaid and CHIP Renewals Outreach and Educational Resources webpage and be sure to download the All Hands-on-Deck Toolkit to get started in your community. Keep the conversation going throughout Open Enrollment! Find your state here to learn more.

    By sharing these resources and information with your networks and communities, you can help continue to improve mental and behavioral health in all communities.

    Let’s be intentional about helping to educate all racial and ethnic minority communities and others who are underserved on ways to better understand the Medicaid unwinding process, their health coverage and how to access care and services. Join CMS and share Medicaid and CHIP renewal information and resources to help more people keep their coverage.

  • Get in the Cloud: Why Thousands of Researchers are Joining ScHARe Think-a-Thons

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    Posted November 1, 2023

    By Deborah Guadalupe Duran, Ph.D.
    Senior Advisory- Data Science, Analytics and Systems, National Institute on Minority Health and Health Disparities

    Luca Calzoni, M.D., MS, Ph.D. Cand.
    Physician and Data Scientist, National Institute on Minority Health and Health Disparities

    Since February 17, 2023, thousands of researchers, educators, students, and community members have gathered at ScHARe Think-a-Thons to join a paradigm shift in health disparities and health outcomes research.

    These Think-a-Thons are part of the Science Collaborative for Health disparities and Artificial intelligence bias Reduction (ScHARe)—a new NIH resource designed to expand access to large health disparities and health outcomes datasets and the data science skills required to analyze them. ScHARe Think-a-Thons offer free training that enables participants to link cloud-based datasets, access federated data, begin learning the Python programming language, and more.

    And we’re just getting started. As we prepare for exciting new phases in the Think-a-Thon series, we want to highlight what participants have gained so far and preview the many opportunities ahead.

    Training Think-a-Thons: Successfully Upskilling to Advance Careers

    People without access to data science tools have gained access for the first time through ScHARe’s Training Think-a-Thons. More than two-thirds of participants report having little to no prior experience in cloud computing or programming languages, and many belong to populations that are historically underrepresented in these fields. In participant polls, nearly all respondents agree that our Training Think-a-Thons have taught them how to access and work with the large datasets hosted on ScHARe and on Terra, the web platform where ScHARe is housed. With these new skills and membership in the ScHARe learning community, participants are poised to make significant novel contributions to health disparities and health outcomes research.

    (Anyone can benefit from Training Think-a-Thons: recordings are posted online two weeks after sessions conclude.)

    Training Think-a-Thons: Asking New Questions to Get Better Answers

    Think-a-Thon participants are enthusiastic about a paradigm shift in health disparities and health outcomes research. More than 90 percent report that they want to learn to use AI tools and cloud computing to conduct new Big Data-driven research in these areas. As one Think-a-Thon participant noted, researchers can use ScHARe’s advanced computing tools and large datasets to figure out “the basis of disparities”—what mechanisms really drive them—and thus yield powerful new approaches to persistent public health challenges.

    Research Collaboration Think-a-Thons: People from Many Disciplines and Career Levels Are Joining to Advance Health Disparities & Health Outcomes Research

    The ScHARe community includes people from many backgrounds and career levels—Python programmers, social scientists, community health workers, and more. Two-thirds have expressed interest in forming cross-disciplinary, multi-level collaborations to generate publishable research using cloud computing and AI tools. Starting in 2024, ScHARe Think-a-Thons will begin directly supporting these research collaborations, with dedicated space for participants to form new research teams or to introduce their existing research teams to ScHARe.

    The first research collaboration Think-a-Thons will focus on Individual Social Determinants of Health (SDOH), structural SDOH, and health outcomes. Think-a-Thon participants have a wide range of research interests—the intersection of the gastrointestinal microbiome, culture, and cognition; demographic impacts on gene expression; improving LGBTQ research through linked datasets; using informatics to improve community-based care; and more. All projects are welcome!

    Coming in 2024: AI Bias Mitigation

    Many Think-a-Thon participants want to tackle an important challenge: bias mitigation and ethical Artificial Intelligence strategies. Several ScHARe Think-a-Thons will focus on this goal.

    AI is a key tool for analyzing large datasets and building new health-related systems, such as algorithms that assess patient risk and guide care. However, its use can also reproduce and amplify existing biases in data. For example, several populations are underrepresented in biomedical and demographic datasets, and when these datasets are biased, AI can also reflect these biases, ultimately leading to incomplete research, missed or delayed diagnoses, and worse health outcomes.

    In 2024, we’ll launch Think-a-Thons to address this challenge. By tapping the diverse expertise of members of the growing ScHARe community, we’ll be able not only to share best practice tools and workflows, but also develop innovative solutions.

    Opportunities for Tailored Think-a-Thons

    We’ve heard participants ask how to use ScHARe in unique settings, such as college-level research methods courses. In May 2023, we responded by launching special tailored Think-a-Thons.

    At our first tailored Think-a-Thon, with more than 60 educators, we outlined how ScHARe’s free tools could help low-resourced colleges and community colleges teach data science and connect their students to this important field. This August, we offered a second tailored Think-a-Thon highlighting how ScHARe can be useful to Tribal Colleges and Universities and Native American-serving institutions. All Think-a-Thons are free and open to the public.

    We welcome suggestions—let us know if there’s a tailored Think-a-Thon you would like to see.

    Join Us!

    In just their first few months, ScHARe Think-a-Thons have become a space for a diverse community of individuals interested in health disparities, health outcomes, and AI bias research. Regardless of your knowledge of data science or cloud computing, you can join Think-a-Thons to build new skills and meet new collaborators. Women and members of groups traditionally underrepresented in data science and health research are especially encouraged to participate. Join us in making data science work for everyone!