The Medicaid Frailty Toolkit is available now, ahead of the January 1 deadline.

Today, we're releasing the Medicaid Frailty Toolkit, free for state Medicaid agencies. It’s code  that helps states find enrollees who likely qualify for the medical frailty exemption under the new work requirements. 

On January 1, more than 40 states must verify who is exempt from the new requirements. The medical frailty exemption — for people with serious symptoms that may not be documented well in standard datasets — is the hardest one to verify. The evidence often depends on medical claims data, and screening tools used by many states miss people who qualify. If an exempt individual is too sick to file the paperwork in time, they may lose coverage.

The toolkit closes that gap. It doesn't make eligibility decisions: it gives states a list of enrollees who likely qualify, and identifies those who may need outreach and more assistance, so caseworkers can assist before anyone is dropped from coverage. It can only help someone keep coverage, never take it away. And the results are published — in a peer-reviewed study in Health Affairs Scholar, this approach identified at least 15% more frail patients than prior algorithms, and reduced the identification gap between race/ethnic groups through the implementation of methods to prevent algorithmic bias.

Few states have time to buy and deploy a new tool before January, so we’re giving ours away. The code and methodology are fully public at github.com/sanjaybasu/medicaid-frailty-toolkit, and state Medicaid agencies that want help getting started can reach us at partnerships@waymarkcare.com.