Most patients—and their providers—discover a lapse in Medicaid coverage at the point of care. This is not only the least convenient moment to learn this information; it is the most expensive.

H.R. 1 will only make this worse. The volume of renewals is about to double, while your staffing stays flat. The old model—a check at the desk and a navigator working a list—was already strained. Now it will break.

This session offers a different operating model. We call it coverage intelligence: the continuous practice of watching every patient's eligibility every month, predicting the next coverage event before the deadline, and acting on it across Medicaid, Medicare, and the Marketplace. You will leave with a framework you can apply at your own center, no matter what tools you run today.

Learning Objectives:

• Explain why point-of-service eligibility checks fail under H.R. 1, and quantify the revenue and access costs of discovering a lapse at the point of care.

• Describe a population-level coverage model built on three capabilities: monthly eligibility monitoring, predictive identification of upcoming coverage events, and timed patient outreach across Medicaid, Medicare, and the Marketplace.
• Apply a practical readiness framework to assess their center's exposure to doubled redetermination volume and build a response plan that does not depend on adding enrollment rep headcount.