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Medicaid Coverage Risk Calculator

What Could Medicaid Coverage Loss Cost Your Health Center?

Estimate the patients, encounters, and revenue that could be exposed to renewal-process disruption and new Medicaid community engagement requirements. Start with the national benchmark or choose your state, then adjust the assumptions to reflect your health center.
CMS renewal benchmark: July 2024 Medicaid & CHIP renewal outcomes. Community-engagement scenarios are model assumptions, not forecasts.
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Your Medicaid population
Encounter & revenue data
Projection
Community-engagement scenario
23% loss among patients modeled as potentially subject to the requirement; historical benchmark from Arkansas, used only as a sensitivity assumption.
Model assumptions
Estimated revenue exposure
$0
12-month directional exposure
Annual patients potentially at risk0
Estimated encounters exposed over selected period0
Renewal-process benchmark10.8%
Community-engagement assumption23%
Renewal-process risk pool0
Community-engagement risk pool0
Estimated overlap removed0
Coverage loss becomes an activation problem when eligible patients do not understand, document, or complete the next required step.
Guideway helps health centers identify risk, activate patients, and drive enrollment, documentation, and recertification through completion.
Sources and assumptions: CMS Medicaid & CHIP July 2024 renewal outcomes; CMS community engagement rule; CBO Arkansas historical benchmark. Community-engagement scenarios and advanced assumptions are directional model inputs, not forecasts.
Directional estimate only. This calculator does not provide actuarial, legal, regulatory, reimbursement, or CMS-certified guidance. Validate assumptions against your organization’s own patient, financial, and state implementation data.

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