MEDICAID MANAGEMENT
Starting January 2027, new federal work requirements make this urgent.
WHY NOW
WHEN
The federal community engagement requirement is scheduled to begin in January 2027.
WHO
Adults ages 19–64 covered through Medicaid expansion.
WHAT
80 hours a month of work, community service, or education, or the income equivalent, unless an exemption applies.
EXEMPTIONS
Categories include pregnancy, medical frailty, caregivers of young children, and substance use treatment.
Exempt still means documented, submitted and re-checked every renewal.
Even for exempt clients, your staff collect and submit the proof, monitor status between renewals, and support work or activities if the exemption no longer applies. VelloHealth handles that work in the field visit.
Federal guidance is still being finalized, and states set their own implementation details.
THE MEDICAID GAP
Whether Medicaid sits with case managers, a dedicated benefit specialist, or an administrator who monitors the process and prompts staff, the same three gaps show up.
Status is invisible at the visit
Clinicians often can’t tell whether a client’s Medicaid is active, lapsed, or about to lapse until the claim is denied.
Paperwork has no home
Proof of income, medical notes, and exemption letters pile up in email, binders, and phones, with nothing tying them to the client.
2027 raises the stakes
Work requirements and exemption documentation add a new monthly task, on top of renewals, for every client in the expansion population.
HOW IT WORKS
1
Know before you knock
Medicaid status, type, and recertification date appear on the client record, with a chip on the visit screen for expansion-eligible clients.
2
Document in the field
Log hours or dollars as the client reports them, record an exemption, and scan the supporting document on the spot.
3
Keep every record together
Entries, exemptions, and documents stay attached to the client in one repository, with reminders so renewals and exemption reviews don’t slip, and records survive staff turnover.
4
See the whole caseload
Clinician, supervisor, and organization reports show who has entries, who is missing documents, and which renewals are coming due.
Office staff can log entries and exemptions from the web app too.
COMMUNITY ENGAGEMENT
Capture each entry in seconds during the visit, with the supporting document attached. Entries without a document are flagged, so nothing is left incomplete.
EXEMPTIONS
Exemption categories configured for each state you serve, with effective and review dates and medical notes scanned from the field. Filing with the state is handled separately by the client or your office.
VELLOHEALTH INSIGHTS
Coverage data rolls up from the clinician to the supervisor to the organization, so leaders can see where documentation is complete and where it isn’t.
Organization overview. Sample data.
MODEL YOUR EXPOSURE
Enter your own numbers. This is simple arithmetic on the values you enter, not a forecast.
Tell us how Medicaid is handled today, and we’ll show you how Vello fits your teams, your EHR, and your states.
