This measure is important because it shows the number of renewals that have come due in a given month but have not been completed.  Reasons for renewal incompletion include customer-requested extensions, pending verification (documentation) from the customer, or not yet processed by DVHA. 

This measure captures the status of Medicaid renewal processing which is a fundamental body of work in health care eligibility operations.  During the COVID-19 pandemic, states were required to keep members enrolled in Medicaid.  This continuous coverage requirement led to unprecedented growth in Medicaid enrollment. DVHA is now “unwinding” from Medicaid continuous coverage. This means that the eligibility units must process renewals and close for procedural reasons for the entire Medicaid population between April 2023 and June 2024.

HAEEU saw a rise in this metrics numbers due to the amount of renewals coming in each month. With each month’s mailing, HAEEU was unable to maintain the previous months workload in addition to those newly coming in. DVHA added an additional resource (Maximus) to support renewal processing and help manage backlogs during this time. The additional resource (Maximus) is set to end on May 31st. The current trendline shows a steep decline from October 2024 to November 2025. VHC MCA customers who had a 12/1 and 1/1 NRD (next renewal date) that did not go ex-parte or partial ex-parte were bumped out to a future NRD in 2025. The reasoning behind this action resulted in the Medicaid Recon team being able to focus on increasing backlogs due to the reduced number of new manual renewals received. MABD had paused their renewals for the months of November and December which is why there was a significant drop in renewal backlogs. We expect to see this number start going back up in January. 
 

Narrative Updated: 12/27/24

• ADPC
• Maximus
• Optum