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'Hit the hardest': Medicaid redetermination one of main causes in RiverStone Health layoffs

'Hit the hardest': Medicaid redetermination one of main causes in RiverStone Health layoffs
Posted at 5:59 PM, May 13, 2024
and last updated 2024-05-14 08:41:21-04

BILLINGS — Riverstone Health announced the layoffs of 29 employees on Friday, citing the loss of over $3 million in Medicaid revenue as one of the main reasons behind the cuts.

In April 2023, the Montana Department of Public Health and Human Services began redetermining who qualified for Medicaid coverage. With Medicaid redetermination, many lost coverage, and with that, the clinic lost reimbursement.

'Hit the hardest': Medicaid redetermination one of main causes in RiverStone Health layoffs

“Everybody’s impacted,” Jon Forte, RiverStone Health president and CEO, said on Friday. “As Medicaid coverage bottoms out, we just simply cannot afford to maintain our status quo, and we’ve had to make some changes.”

Over 134,000 people were kicked off Medicaid statewide.

“We’re getting hit the hardest,” Forte said.

'Hit the hardest': Medicaid redetermination one of main causes in RiverStone Health layoffs

Before redetermination, 7,000 of Riverstone's 14,000 patients had Medicaid coverage. They’ve since lost 1,700 of those patients.

“People are losing coverage who might still be eligible to receive Medicaid benefits if they get all of their paperwork and applications worked out,” Mara Silvers, a Montana Free Press Health reporter who covers healthcare, said.

'Hit the hardest': Medicaid redetermination one of main causes in RiverStone Health layoffs

Nearly 85,000 people were determined ineligible for coverage because they failed to provide the requested information.

No coverage means no reimbursement for their providers.

“We have heard from some other industry representatives that Medicaid redetermination is impacting their bottom line,” Silvers said.

Industries like long-term care facilities and nursing homes.

“We've been very impacted by the Medicaid redetermination,” David Trost, the CEO of St. Johns United, said. “The financial conditions and the eligibility of seniors, who once they qualify for assisted living or nursing home benefits, there isn’t a reason for them to not qualify.”

In the nursing home at St. John’s United in Billings, most of their 100 clients on Medicaid were deemed ineligible for coverage during redetermination.

Nursing homes and health care providers are awaiting reimbursement money that goes towards staff and patient care.

“Everybody impacted by this reduction needs to know that they didn’t do anything wrong,” Forte said.

According to Forte, about 20 of the 29 layoffs came out of the federally qualified health center.

"We are not going away. We're not going to close our doors. We're not going to turn you away because you've lost your Medicaid coverage," Forte said.