Dive Temporary:
- Medical billing tech agency Cedar launched a device Monday that goals to assist sufferers enroll in and keep Medicaid protection because the healthcare sector braces for main cuts to the safety-net insurance coverage program.
- The product, known as Cedar Cowl, identifies sufferers who could also be eligible for Medicaid, reminds beneficiaries of upcoming eligibility checks, helps them handle care denials and connects them to medicine co-pay help, the corporate introduced on the HLTH 2025 convention in Las Vegas.
- The device comes months after President Donald Trump signed an enormous tax and coverage regulation that features historic cuts to Medicaid. “This invoice goes to straight drive will increase in uninsured affected person care,” Seth Cohen, president of Cedar, mentioned at HLTH.
Dive Perception:
The One Huge Lovely Invoice Act strips greater than $1 trillion from federal healthcare spending over the subsequent decade, largely via cuts to Medicaid.
One of many largest modifications included within the regulation are work necessities, which mandate Medicaid beneficiaries log work, training or volunteer hours to remain enrolled in protection.
The necessities are controversial: Whereas Republicans argue the coverage preserves the safety-net program for probably the most needy, research present earlier experiments by states to enact work mandates eliminated individuals from protection with out rising employment. Eligible individuals is also eliminated as a result of they wrestle to navigate the reporting course of, opponents say.
An extra 10 million individuals might be uninsured in 2034 as a result of regulation, in response to the Congressional Finances Workplace. That poses new monetary challenges for suppliers, who will doubtless lose income and see uncompensated care prices spike.
“That is massively devastating for suppliers who not have the […] reimbursement, and, after all, for the sufferers who can’t cowl these losses,” Cohen mentioned.
Cedar Cowl goals to assist sufferers via the Medicaid enrollment course of and alert present beneficiaries of upcoming work requirement and eligibility verify deadlines.
Sufferers full an eligibility display to find out whether or not they might qualify for help, and the device walks them via enrollment if they seem eligible, a spokesperson instructed Healthcare Dive.
As soon as they’re enrolled within the safety-net program, Cedar makes use of the approval date to ship reminders about work necessities and renewal dates utilizing state-specific information from companion Fortuna Well being, a Medicaid navigation platform.
The product may also information sufferers on learn how to resolve claims denials and pair them with medicine help. Along side Cedar’s funds platform, the monetary help device integrates with main digital well being data, like Epic, a spokesperson mentioned.
Practically a dozen well being techniques use Cedar Cowl, together with Novant Well being, Baystate Well being and the Iowa Clinic, in response to a press launch.
