BeneStream has enrolled thousands of Medicaid patients for companies that seek out their services BeneStream has enrolled thousands of Medicaid patients for companies that seek out their services and the New Orleanes Times Picayune ran a story on BeneStream and the opportunity it provides Louisiana businesses to expand their health insurance offering and save money.

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Medicaid expansion in Louisiana has long been pitched as a way to save the state money, get uninsured people healthier and help stabilize Louisiana’s fragmented health care system.

But for the New York-based BeneStream, Medicaid expansion also has created a business model. The company’s CEO, Benjamin Geyerhahn, founded the company on the idea that because the working poor stood to benefit the most from Medicaid expansion, there were probably going to be companies out there that needed help ensuring their employees enrolled.

Geyerhahn was right: Since states began expanding Medicaid under the Affordable Care Act, BeneStream has enrolled thousands of Medicaid patients for companies that seek out their services because large numbers of their employees don’t earn enough to pay for private insurance. BeneStream, in essence, becomes something like a human resources department on contract for companies with workers who would otherwise be uninsured without Medicaid expansion.

The people BeneStream enrolls in Medicaid provide a compelling look at the types of employees that Medicaid expansion will affect. There are home health aides, people who clean hotel rooms and people who work in nursing homes. There are people who work in industrial dry cleaning plants and even cooks who work for high-end restaurants.

Cards will be issued June 1, with about half of the recipients being automatically enrolled.

“Home health aides make between $9 and $12 an hour,” Geyerhahn said. “Most of those folks, if they have children, that’s $480 a week, $24,000 a year. If you have two children, that qualifies you.”

That’s why so many people — about 375,000 — in Louisiana are going to qualify for Medicaid expansion, which Gov. John Bel Edwards authorized by executive order  Jan. 12. Louisiana has some of the highest poverty rates in the nation and some of the worst health outcomes, but much of that problem centers on people who go to work at jobs that don’t provide benefits and don’t make enough to pay for their own insurance.

In many ways, BeneStream is benefiting from a difficult truth about Medicaid: It’s not always easy to enroll. And it can be difficult for some people who should qualify for the program to navigate state Medicaid programs if their application is denied.

“The state gets it wrong a lot — there’s a lot of complexity in enrolling in Medicaid,” Geyerhahn said. “There are life events that can change (eligibility) — a new child, a marriage, a raise in salary, all of those can impact eligibility.”

So BeneStream has built expertise around Medicaid eligibility after expansion, and its staff often spends time either on the phone or on site at a company interviewing employees about their family situations and their incomes. In many cases, applicants have been denied Medicaid because of a family situation that the state thinks would disqualify them from the program.

The savings could be used as a weapon against legislators trying to undermine the governor’s plans to expand Medicaid.

If BeneStream thinks the state misunderstood the situation, they will get on a three-way call with a state Medicaid enrollment worker and the enrollee, and help explain to the enrollment worker why the person should qualify. The enrollees often don’t have the knowledge to be able to challenge a denial, Geyerhahn said, but BeneStream workers do.

“Our policy team is better at this than any lawyer we’ve run into yet,” Geyerhahn said. For instance, there’s a county in New Jersey that’s not very timely in their Medicaid enrollment.

“We have a tickler where if you enroll someone in this county, we make sure even if we’ve heard over the phone that on day 60 they’ll distribute a (Medicaid) card, on Day 55, the enrollee will get a call” from a BeneStream employee making sure the person’s signed up, Geyerhahn said. “If they haven’t, we immediately call someone.”

Companies pay $250 a year per employee for the service.

BeneStream has been particularly successful in states such as Nevada where there isn’t a lot of publicity surrounding Medicaid expansion. Many of the low-wage workers there weren’t aware they were covered by Medicaid, Geyerhahn said, so the company had a lot of success being hired by casinos who employ large numbers of low-wage workers — housekeepers, dishwashers and cooks.

It was obvious that Louisiana had more publicity surrounding expansion, Geyerhahn said, because it didn’t have to do much outreach to to start talking to potential clients.

“The fact that employers are already getting in touch with us indicates that awareness has gotten a level deeper,” Geyerhahn said.

Bob Bartles, executive director of the nonprofit Hope Haven in Burlington, Iowa, said he decided to hire BeneStream because so many of his employees earn about $11.25 an hour. The nonprofit helps people with disabilities.

“Our experience with health insurance has been very painful,” Bartles said. “The cost kept going up but the quality of coverage kept going down. People were paying more for less services.”

Many of his employees were eligible for Medicaid expansion but didn’t know it. After hiring BeneStream, Bartles said, many of his employees began Medicaid enrollment and saved money because they weren’t buying the private insurance the nonprofit provided.

“We want everyone to have health insurance and we’re OK if it’s us, and we’re OK if it’s Medicaid,” Bartles said. “It’s a wonderful thing, and particularly where dollars are precious, it’s a real cool deal to get better health insurance.”