Automated Medicaid Renewal Reminders
State of Rhode Island / Deloitte · Rhode Island, USA · 2016
Summary
Rhode Island's Medicaid renewal reminder experiment addressed one of the most common causes of coverage gaps: members who are still eligible but miss renewal paperwork deadlines. The 23 percentage point improvement in on-time renewal came from a simple sequence of automated contacts that mailed notice alone did not provide. Coverage gaps are costly both for members (uninsured periods, delayed care) and for states (re-enrollment processing, emergency care costs for uninsured periods). The study has been replicated in Connecticut, Colorado, and several other states with consistent results in the 15–25 percentage point range.
Research question
"Do automated SMS and phone reminders reduce Medicaid coverage gaps due to missed renewals?"
Methodology
Intervention
Members due for renewal randomly assigned to receive automated SMS/phone reminders at 60, 30, and 7 days before renewal deadline vs. standard mailed notice only
Assignment
Randomized controlled trial (member)
Sample size
14,000 Medicaid members
Primary outcome
On-time renewal rate; coverage gap duration; re-enrollment after coverage lapse
Effect estimate
On-time renewal: +23 percentage points; coverage gap rate: -31%; average gap duration among those who lapsed: -12 days
Decision
Rhode Island made automated reminders permanent; model adopted by 8 additional states
Result
Positive
On-time renewal: +23 percentage points; coverage gap rate: -31%; average gap duration among those who lapsed: -12 days
Evidence strength
Strong
Randomized trial, replicated across multiple sites or studies.
Replication status
Replicated
Institution
State of Rhode Island / Deloitte
Location
Rhode Island, USA
Year
2016
Policy area
Benefits Enrollment
Mechanism
Information