Epiphany Management Group today expanded its Medicaid member engagement and support services with REACH, helping health plans, providers and states protect coverage for eligible members as H.R.1’s new redetermination and work requirements take effect January 1, 2027.

REACH, which stands for “Retention-driven Engagement Actions for Coverage and Healthcare”, offers a fast, scalable way to manage increased outreach demands, while helping members stay engaged through the changes.

Under H.R.1 (the One Big Beautiful Bill Act, signed July 2025), states must redetermine Medicaid eligibility every six months, rather than annually, for around 20 million adults covered through the ACA expansion. Many must also show 80 hours per month of qualifying work, education or community service unless exempt, although some states may seek extensions to the work requirement.

The greatest risk is eligible people losing coverage over paperwork. About 70% of disenrollments during the post-pandemic unwinding were procedural, according to KFF. Awareness is also low: a 2026 industry survey found 85% of enrollees did not know redetermination frequency is changing. For health plans, that means churn and lost revenue. For providers, it means interrupted care, and for states, a heavier administrative and verification burden.

REACH gives organizations a dedicated outreach and support function for redeterminations and work requirements. It combines trained, U.S.-based service agents with data-driven prioritization and omnichannel outreach, and can be stood up quickly alongside existing teams.

“Health plans, providers and states face three converging forces: significant budget cuts, sweeping new rules and regulations with tight timelines, and genuinely transformative technology like AI arriving in the middle of it,” said Suranjan Shome, CEO of Epiphany Management Group.

“We built REACH to overcome these challenges in consultation with states, providers and managed care organizations,” Shome added. “Not only is the deadline fast approaching, but we’re concerned about the direct impact on members if organizations aren’t ready. We’re here to provide a practical solution, grounded in years of hands-on experience in Medicaid.”

REACH is built around four integrated services covering redeterminations and work requirements end to end:

  • Retention Sprint Desk. Inbound and outbound support across every redetermination cycle, from pre-notice contact validation to outcome reporting. The most intensive outreach goes to members at highest risk of losing coverage.

  • Work Requirement & Advocacy Hub. Dedicated compliance coaches educate members, guide them through activity reporting, and proactively identify those who qualify for exemptions.

  • Member Intelligence & Continuous Improvement. Engagement data feeds reporting, campaign playbooks and updated member records, sharpening outreach and strengthening retention over time.

  • Member Engagement Platform. Integrated data, outreach and support across voice, SMS, email, IVR and chat, built to scale without proportional increases in staffing or cost.

To learn more about REACH, call (888) 364-4512 or email info@epiphanymgmt.com

Read Epiphany’s guide for health plans: Get Ready For Medicaid Redeterminations Under H.R.1

About Epiphany Management Group

Epiphany Management Group is a HIPAA-compliant partner specializing in Medicaid member engagement and support. For nearly a decade, Epiphany has worked with organizations delivering complex Medicaid programs in more than 20 states, achieving a 97% member satisfaction rate. Its service agents are selected for empathy and a consultative, problem-solving mindset, then trained on program policy and client processes. Epiphany has a 100% U.S.-based workforce, holds MBE certification, and is headquartered in Akron, Ohio.

https://epiphanymgmt.com/

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