BC Advantage - 2026 Issue 4
After Open Enrollment, The Real Coverage Disruption Begins
Why QLE-driven churn is fueling uncompensated care, and what revenue cycle teams must do now Post-open enrollment is now one of the most volatile coverage periods of the year for U.S. health systems, driven by a steady rise in qualifying life events, including job transitions, residency changes, and Medicaid redeterminations that cause patient coverage status to change midstream outside the traditional enrollment cycle. With more than 25 million patients disenrolled since the start of Medicaid unwinding and the 2026 HDHP out-of-pocket maximum set at $17,000 for family coverage, revenue cycle teams face a dual threat: coverage...
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