Blog

Representing the unrepresented

Everett Lebherz — Wed, 08 Apr 2026 16:59:58 GMT

What the new Pointcare patient experience says about who we are, what we believe, and why it matters to every health center we serve.

Everett Lebherz

CO-FOUNDER & CEO, POINTCARE

Building for the Moment When Coverage Matters Most

hello@pointcare.com (Pointcare) — Tue, 24 Mar 2026 03:50:03 GMT

Building for the Moment When Coverage Matters Most

Written by: Everett Lebherz, CEO & Co-Founder of Pointcare

Coverage Continuity As Infrastructure

hello@pointcare.com (Pointcare) — Thu, 12 Mar 2026 00:12:48 GMT

Coverage Continuity As Infrastructure

Written by: Everett Lebherz, CEO & Co-Founder of Pointcare

Navigating the Shutdown: Why Medicaid Stability Matters Now

hello@pointcare.com (Pointcare) — Fri, 03 Oct 2025 15:57:04 GMT

Navigating the Shutdown: Why Medicaid Stability Matters Now

Written by: The Pointcare Team

CEO: Why your Manual Enrollment Process Won't Survive Past 2025

Everett Lebherz — Wed, 06 Aug 2025 06:26:58 GMT

Why Your Manual Enrollment Process Won't Survive Past 2025

Written by: Everett Lebherz, CEO & Co-Founder of Pointcare

When Redeterminations Rise, Keep Patient Experience High

mmoon@pointcare.com (Meredith Moon) — Wed, 06 Aug 2025 06:24:24 GMT

When Redeterminations Rise, Keep Patient Experience High

Written by: Meredith Moon, Head of Partnerships @ PointCare

Why the PointCare Covee Awards Matter

Jesse Brooks, Head of Customer Engagement — Tue, 01 Jul 2025 19:56:22 GMT

Why the Pointcare Covee Awards Matter

Written by: Jesse Brooks, Head of Delivery at Pointcare

Preparing for the Unknown

Everett Lebherz — Mon, 09 Jun 2025 20:44:48 GMT

Preparing for the Unknown

Written by: Everett Lebherz, CEO & Co-Founder of PointCare

The Heart of the Matter

rmetzinger@pointcare.com (Rita Metzinger) — Tue, 13 Aug 2024 17:00:00 GMT

What does it mean when a patient falls out of coverage? Practically speaking, we understand the nuts and bolts operationally of what that means. In our recent blogs we covered the financial burden redeterminations have on clinics and one of the primary causes clinics and patients are caught unaware. But when we get to the heart of the matter, the loss of Medicaid is more than percentage points and lost clinic revenue. It is something that impacts the most vulnerable communities in all of our backyards.

What’s Wrong with Redetermination Lists?

rmetzinger@pointcare.com (Rita Metzinger) — Mon, 08 Jul 2024 18:00:00 GMT

More than a year after the Unwinding, navigating Medicaid coverage management has only become more complex. In a recent study, FQHCs reported that 1 in every 4 of their Medicaid patients are experiencing lapsed coverage—most without even realizing it. As of May 2024, the largest percentage of Medicaid terminations, 70%, were procedural - which means patients who could still qualify for Medicaid benefits are being dropped from coverage for avoidable reasons, usually due to paperwork.

One of the most complicated aspects of coverage management is keeping track of if and when patients have lapsed. In theory, redetermination lists help clinics manage their patients and ensure eligible individuals maintain continuous access to healthcare coverage. However, these lists have proven ineffective at catching Medicaid members who lapse for procedural reasons—mainly because they usually are not on these redetermination lists.

People can fail to show up on Medicaid redetermination lists due to changes in residency, missing or changed contact information, or administrative errors. If redetermination lists only showcase the patients with known and updated data, they unintentionally miss out on the rest of the patient population potentially eligible for redetermination of their Medicaid. This causes headaches for the providers who are caught in a cycle of perpetual re-enrollment at point-of-care and patients who may have to forgo medical treatment if they find themselves without coverage. It is unsustainable.

To be fair, these unexpected gaps in Medicaid coverage existed long before the COVID-19 pandemic. In a recent interview with us, Salliann Alborn, the CEO of MCHS, an IPA in Maryland with close to 80,000 Medicaid members, noted that her team had witnessed Medicaid members being dropped from coverage unexpectedly prior to the PHE and that the redetermination lists they were working from were historically inaccurate. Fortunately, PointCare’s coverage management solutions are readily available to help healthcare providers engage and re-cover patients who have fallen out of coverage and didn’t land on a redetermination list. Our solution provides proactive identification and resolution of coverage issues to ensure continuity of care, improving the Medicaid member’s coverage experience.