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Community Benefits, the Icing on the Medicaid Eligibility Cake

Lucy's Medicaid Minute

By Lucia Buffaloe, MBA - Director

June 2021

This is my first edition of Lucy’s Medicaid Minute. The theme of this blog will be to highlight important issues and challenges that providers and patients face when it comes to qualifying for federal and state eligibility programs. I’ll also provide CBIZ’s perspective on key eligibility issues and how we are assisting our clients and their patient populations.


I wanted to start off the blog by talking about community benefits, aspects of eligibility that are often overlooked. Although many firms can assist with enrolling patients in Medicaid, for example, many fail to qualify patients for additional entitled benefits – benefits that can be critical to patient health and well-being. Here are two important points about community health benefits to talk about with your internal teams:

How does assisting patients with obtaining community benefits help your hospital or health system?

Medicaid-insured recipients may also be eligible to receive additional benefits, such as cash assistance, food stamps, home energy payment relief and other available programs. By contributing to the improvement of the overall community health, your hospital establishes deepening community relationships and an improved public image. Data has shown that these benefits will lead to patients who are less likely to have unnecessary ED visits, readmissions and other negative post-discharge outcomes.

Why should your Medicaid eligibility vendor provide this service?

Medicaid eligibility is more than just completing an application. In this new era of population health, Medicaid eligibility is the gateway to the patient and their family gaining access to healthcare and community support services that will not only address a specific health event but will put them on the path to a healthier and better life. Many vendors only focus on the Presumptive Eligibility (PE) aspect of Medicaid eligibility. This may address a patient’s current healthcare event, but it will miss the bigger picture. Your vendor’s mission should be your own: helping to improve the health of your community. These community health benefits drive better patient engagement with a hospital, leading to an increased sense of trust and improved patient health. By helping patients with these vital community benefits, the odds are greater that they will be more receptive and cooperative. The effects are manifold, but remember two of them: healthier patients and happier families.

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