CINCINNATI, Ohio, Nov. 02, 2026 (GLOBE NEWSWIRE) — Ensemble today announced the expansion of its intelligent financial advocacy capabilities to help health systems proactively identify patients at risk of losing insurance coverage, support financial assistance eligibility screening and guide eligible patients through convenient digital, state-specific Medicaid enrollment processes.

Across the country, hospitals continue to face increasing pressure from Medicaid redeterminations, administrative complexity and changing reimbursement dynamics. That pressure is expected to intensify beginning January 1, 2027, when most adults enrolled through Medicaid expansion will be required to renew their eligibility every six months rather than annually and comply with changing work requirements, increasing the risk of coverage loss due to missed notices, documentation challenges and other administrative barriers.

Ensemble’s strategy is to help health systems move from a reactive response to a proactive preparedness model, combining patient outreach, exemption screening, financial navigation, eligibility support and operational readiness to address both Medicaid redeterminations and the new work requirement landscape.

“Helping eligible patients maintain insurance coverage is critical because even a temporary loss can delay care, disrupt treatment and create financial hardship for patients and providers,” said Jim Gaffney, Ensemble’s Chief Strategy Officer. “Too often, patients lose coverage because of process barriers rather than true ineligibility. Our goal is to identify risk earlier, simplify the enrollment journey and help health systems reduce avoidable self-pay while improving access to care.”

Moving Beyond Eligibility Screening to Protect Patient Coverage

Ensemble’s approach begins by combining coverage discovery data from multiple sources with its extensive patient intelligence to determine which patients may be uninsured or underinsured and what assistance they may qualify for. Ensemble then applies intelligence about patient communication preferences to determine the right channel and timing for engagement.

Those insights power a coordinated patient engagement ecosystem spanning digital, voice and onsite support. Connections with electronic health record (EHR) systems allow Ensemble to leverage native EHR functionality for patient communications, including patient portal messaging and other digital engagement channels.

For voice outreach, Ensemble combines Sierra’s leading voice-agent technology with human-empathy principles and patient-experience best practices, enabling outreach at scale while preserving the sensitivity these conversations require. A convenient digital application portal helps patients provide information and complete applications, while onsite financial assistance experts offer screening, counseling, documentation support and hands-on help for patients who need or prefer personal assistance.

Ensemble is also helping health systems prepare for new Medicaid work requirements through targeted patient outreach, deadline reminders and educational resources that explain reporting and documentation requirements.

Key capabilities include:

  • Coverage discovery using insurance information from multiple sources to build a more complete view than insurance-on-file status alone
  • Predictive patient analytics that help identify potential eligibility and inform outreach before engagement begins
  • Integration with electronic health record tools to support patient portal messages and coordinated digital communications
  • Proactive, conversational voice agent outreach powered by Sierra, with escalation to financial assistance experts for complex situations
  • A convenient digital application portal that helps patients provide information and complete enrollment or assistance applications across all 50 states
  • Onsite screening and application support from financial assistance experts
  • Outreach within 24 hours following unplanned care, including emergency department and urgent care visits
  • Continual improvement with feedback from every patient interaction

“The opportunity is much larger than automating conversations or supporting digital Medicaid applications,” said Steve Hammond, Ensemble’s President. “It’s about helping patients navigate complex processes and requirements, connecting them to coverage faster and reducing avoidable financial hardship. We’re helping nearly 50,000 patients identify coverage options each month, which means greater access to care and more financial stability for families.”

Frequently Asked Questions

What is Ensemble’s nationwide coverage retention initiative?

Ensemble’s nationwide solution starts with coverage discovery and predictive patient analytics that combine insurance information from multiple sources with robust patient insights. This helps identify who may be uninsured or underinsured, what coverage or assistance they may qualify for and how best to engage them before outreach begins. The solution then connects electronic health record tools, digital communications, Sierra voice agents, a digital application portal and onsite financial assistance experts through submission and active tracking.

How does Ensemble help patients retain or secure Medicaid coverage?

Ensemble engages patients through patient portals, text messages, email, voice-agent conversations, a convenient digital application portal and onsite experts. Outreach occurs before planned care, during registration, or within 24 hours after unplanned care, including emergency department and urgent care visits. Patients receive eligibility screening, state-specific guidance, application support and escalation to financial assistance experts when needed.

Does Ensemble support Medicaid enrollment in every U.S. state?

Yes. Ensemble supports state-specific Medicaid enrollment requirements across all 50 states.

How can this initiative benefit health systems?

The initiative can help health systems engage eligible patients sooner, reduce avoidable self-pay, limit preventable uncompensated care and use financial advocacy resources more strategically.

How do virtual agents and financial advocates work together?

Voice agents provide proactive, conversational outreach at scale, answer routine questions, gather information and guide next steps. They work within Ensemble’s broader engagement model, which includes digital communications and application tools, while financial assistance experts provide onsite screening, counseling, documentation support and help with complex applications.

Who may benefit from Ensemble’s Medicaid enrollment support?

Patients who may qualify for Medicaid but face renewal, documentation or enrollment barriers may benefit, as well as health systems seeking a scalable approach to coverage retention and financial advocacy.

About Ensemble

Ranked #1 revenue cycle management partner consistently by providers, Ensemble manages end-to-end revenue cycle operations for more than 35 health systems nationwide. Through a combination of certified revenue cycle operators, data-rich intelligence and advanced AI, Ensemble helps healthcare organizations sustain best-practice revenue cycle operations and maximize their current technology, so providers can focus on delivering exceptional care in their communities.

For more information, visit EnsembleHP.com or contact media@ensemblehp


Sarah Joyce
Ensemble 
6263799829
Sarah.joyce@ensemblehp.com

Media gallery

About The Author
Ensemble Health Partners