Four actions to improve Medicaid contact center performance

More than a year into the unwinding of the Medicaid continuous-coverage provision, state Medicaid agencies have been grappling with a surge of inquiries as millions of Medicaid enrollees renew their coverage for the first time in three years.¹Jennifer Wagner, “Understanding unwinding: What to know about Medicaid call center data,” Center on Budget and Policy Priorities, July 6, 2023; “Extension of temporary unwinding-related flexibilities,” Centers for Medicare & Medicaid Services, May 9, 2024. At the same time, Medicaid enrollment is rising.²Elizabeth Hinton et al., “Medicaid enrollment and spending growth amid the unwinding of the continuous enrollment provision: FY 2023 & 2024,” KFF, November 14, 2023. These changes have led to escalating call volumes at contact centers that,³“Medicaid and CHIP CAA reporting metrics,” Data.Medicaid.gov, updated August 30, 2024. combined with understaffing compared with prepandemic levels,⁴Medicaid and CHIP eligibility, enrollment, and renewal policies as states prepare for the unwinding of the pandemic-era continuous enrollment provision, KFF, March 2023. have emerged as a pain point for state Medicaid agencies and their clients. Mandatory reporting of call-center metrics⁵Jennifer Wagner, “Understanding unwinding: What to know about Medicaid call center data,” Center on Budget and Policy Priorities, July 6, 2023. has drawn attention to long wait times and high abandonment rates across the nation, fueling concerns that suboptimal contact-center operations could be reducing access, causing poor customer experience, driving up operational expenses, and straining employee morale.

This article explores the current challenges facing Medicaid and other government agencies with their contact-center operations and presents four actions to help improve performance and better meet constituents’ needs.

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