Work requirements begin
Medicaid work requirements, which CMS calls community engagement requirements, must begin by January 1, 2027. States may start earlier.
New Medicaid rules start January 1, 2027See what changes
Help patients keep the Medicaid coverage they qualify for
MediKey is Medicaid renewal software for health systems, FQHCs, behavioral health providers and community organizations. It reaches patients by text and phone before their deadline, and it runs alongside your EHR.
Hegira Health in Michigan and St. Thomas in Louisiana use MediKey.
The law
What changes on January 1, 2027
These are the federal rules. States run Medicaid and decide how to carry them out, so what applies to your patients can differ by state.
Renewals every six months for expansion adults
Adults covered through Medicaid expansion move to eligibility renewals every six months, starting with renewals initiated on or after January 1, 2027. More renewals mean more deadlines for patients and staff to keep track of.
Source: CMS Informational Bulletin, December 8, 2025 (opens in new tab)
Less time to go back
From January 1, 2027, coverage can reach back one month before an application for expansion adults, and two months for everyone else. A gap has to be caught before it happens.
Sources: Medicaid.gov summary of P.L. 119-21 (opens in new tab); CMS letter SMD 26-001, March 6, 2026 (opens in new tab)
Paperwork caused most coverage loss last time
More than 25 million people lost Medicaid in the 2023 to 2024 unwinding. 69% of them lost it for paperwork or procedural reasons.
Source: KFF (opens in new tab)
How it works
How MediKey keeps people covered
Patients get a reminder they can act on, and help when they need it. Your staff get one clear list instead of a pile of deadlines.
Find who needs help first
MediKey reads your Medicaid patient list and your EHR to show whose renewal is coming up, who may already have a gap, and who needs the most help.
Reach people early
Patients get text and phone reminders well before their deadline, in your organization’s name, instead of a paper notice that may never arrive.
Help them finish
People fill in forms and upload documents on their own phone, with nothing to download.
Follow every renewal through
Your team sees each renewal from the first reminder to the decision, so nothing is lost once the paperwork leaves the clinic.
Results
What changed in our pilot
- 94%
- renewal completion rate
- 2.3×
- more exempt patients found than manual review
- 60%
- less staff time on renewal outreach
Your patients
How many of your patients could lose coverage?
Enter your state, how many Medicaid patients you serve and your organization type. The estimate uses published projections.
Based on published projections from the Urban Institute, Congressional Budget Office, and Commonwealth Fund (2025)
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Two ways to run it
Run MediKey with your own team, or have ours run it for you
It is the same MediKey either way. The difference is who reaches out to patients and helps them finish.
Your team runs it
Your eligibility staff and navigators work from MediKey every day. We set it up around your EHR and the states you serve, train your team and support them after launch.
A good fit for
- Health systems and FQHCs with eligibility or navigation staff
- Behavioral health providers with care coordinators
- Organizations already using HealthBase, where MediKey switches on inside it
ITO staff run it for you
Trained ITO navigators work MediKey on your behalf, from the first reminder until each renewal is decided.
A good fit for
- Organizations without staff to spare for renewals
- Teams facing more renewals under the new rules
- Programs that want renewals handled without hiring for it
ITO runs it for you
Our navigators help your patients finish their renewals
ITO’s trained navigators work from MediKey in your organization’s name. They follow up with patients who have not responded, help them gather documents and finish the forms, and stay with each renewal until the state decides.
Your team approves the messages and sees every renewal’s status. Patients still hear from you.
Follow-up
Calls and texts to patients who have not replied to their reminders.
Paperwork
Help gathering documents and finishing renewal forms on their phone.
Exemptions
Help with the paperwork for patients MediKey flags as likely exempt.
Reporting
A clear view of renewals completed and coverage kept.
Questions
Common questions
How long does it take to get started?
Most organizations using MediKey on its own go live in six to eight weeks. If you already use HealthBase, MediKey can be running in two to four weeks. Both assume standard access to your EHR and a person on your team who knows your eligibility process.
Which EHRs does MediKey work with?
MediKey connects to Epic, Cerner, athenahealth and eClinicalWorks through standard FHIR connections. If you use another EHR, we will look at what it would take on a short call.
Who do patients hear from?
Your organization. Messages go out in your name, and your team approves them before anything is sent. If you would rather not run outreach yourselves, ITO staff can do it for you with your approved messages.
Does MediKey replace our eligibility staff?
No. It takes the tracking and reminders off their plate so they can spend their time on the patients who need a person.
Do the rules differ by state?
Yes. States run Medicaid and decide how to carry out federal rules, including how far back coverage can reach. MediKey is set up for the states you serve.
Talk with us before the next renewal notice goes out
We will walk through how MediKey would work with your team, your patients and your EHR.