Medicaid redetermination continues to be one of the biggest challenges facing health plans. With new regulations, like bi-annual redetermination and work requirements, as a part of the One Big Beautiful Bill Act, millions of members are at risk of losing coverage causing concerns around member retention for payers. The last time we were hearing about redetermination regulations was post-PHE in spring of 2023, when the continuous enrollment policy set during the pandemic was lifted. Misunderstandings and member confusion arose, leading to 19% of members losing their Medicaid coverage, many due to procedural reasons.

Additionally, a recent study in the Health Forum of the Journal of the American Medical Association, came out calling out the detriments of procedural disenrollment specifically for the 13 million Americans who are dual-eligible, meaning they are enrolled in both Medicaid and Medicare. The study indicated that 8% of these individuals lost Medicaid coverage for at least one month per year, mostly due to procedural reasons, like incorrect or missed paperwork. Disruptions in coverage can be particularly harmful for the dual-eligible population given their age and specific health concerns.

For both the dual-eligible and standard Medicaid populations, health plans have the opportunity to get ahead of the confusion and get in front of their members with the right information to prevent any procedural disenrollments. But when it comes to redetermination, according to Gartner, the key to success isn’t a one-time campaign—it’s delivering continuous, trusted communication that guides members through the redetermination process and beyond.

Relay’s content delivery channel—combining SMS with feed technology—is uniquely built for this moment. By making redetermination simpler, more secure, and more personal, Relay helps health plans not only keep eligible members covered but also create lasting value across the member lifecycle.

Our approach meets members where they are—on their phones—without requiring an app download, login, or portal navigation. According to a BCG study, “Reaching Medicaid Members Where They Are,” when asked which devices they use to access the internet, 96% of Medicaid members said they use their smartphone. Given the high adoption and utilization of smartphones with the Medicaid population, Relay health payer clients have found that the combination of SMS and scrolling feed works well for this population. In fact, more than 2.4 million Medicaid members are already using Relay Feeds.

Accessibility makes a difference, especially with the populations of people who are looking to renew their coverage. When confusion and low trust can derail the process, it is more important than ever to ensure members have clear access to the resources they need.

Gartner notes that in order to strengthen the end-to-end member experience, starting with redetermination, plans should invest in technologies that “are multi-experience; you cannot rely on members to download an app or login to a portal.” Additionally, they mention tools that “personalize experiences so communication methods—and reading levels—meet diverse member preferences.”

Relay recently released Spanish Feed capabilities, allowing clients to deliver end-to-end member feed experiences in Spanish. This feature provides equitable access to all members who speak Spanish to receive the same critical messages that support the redetermination process and beyond.

In addition, Relay supports two-way chat through Relay Messenger, our push-to-chat solution embedded right within Relay Feeds. Many Relay clients use this functionality to chat one-on-one with Medicaid members in a secure and compliant way to answer questions and provide resources as needed.

By providing access in these ways, Relay ensures members actually get messages that help them to know what to do, when to do it, and why it matters.

Relay has proven to help Medicaid payers retain coverage for eligible members—and then continue building healthier, more cost-efficient relationships well beyond redetermination. Below are some Relay-client results in redetermination efforts:

Relay clients have achieved these results by strategically delivering these critical communications to members on our trusted and secure mobile-first channel.

While redetermination is critical, it’s not the end goal. Members need clear, timely guidance across every stage of their healthcare journey. Relay extends beyond redetermination with journeys that improve health outcomes and business results, including:

Relay’s scrolling feed format feels familiar and trusted, enabling payers to deliver the right message at the right moment. And as a mobile-first solution, Relay Feeds have proven their success with the Medicaid and dual-enrolled populations.

As Medicaid redetermination grows more complex, health plans cannot afford to rely on outdated communication methods that leave members confused or disconnected. Relay provides a proven, secure, and accessible way to guide members through redetermination and sustain trust across their entire healthcare journey. By meeting members where they are—on their phones—and delivering timely, personalized information in a familiar feed format, Relay ensures that payers protect coverage today and strengthen member relationships for tomorrow.

To see a Relay Feed in action, click the link below:

To learn more about how Relay can support your team in their redetermination efforts, reach out to sales@relaynetwork.com. 

Read more about Relay’s success with redetermination:

Want to see Gartner’s full guidance on how healthcare leaders can improve the Medicaid redetermination process?