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What the C-Suite should know about CECL and change management

Read this if you are at a financial institution. 

Some institutions are managing CECL implementation as a significant enterprise project, while others have assigned it to just one or two people. While these approaches may yield technical compliance, leadership may find they fail to realize any strategic benefits. In this article, Dan Vogt, Principal in BerryDunn’s Management and IT Consulting Practice, and Susan Weber, Senior Manager and CECL expert in BerryDunn’s Financial Services Practice, outline key actions leaders can take now to ensure CECL adoption success.  

Call it empathy, or just the need to take a break from the tactical and check in on the human experience, but on a recent call, I paused the typical readiness questions to ask, “How’s the mood around CECL adoption – what’s it been like getting others in the organization involved?” The three-word reply was simple, but powerful: “Kicking and screaming.”  

Earlier this year, by a vote of 5-2, the FASB (Financial Accounting Standards Board) closed the door to any further delays to CECL adoption, citing an overarching need to unify the industry under one standard. FASB’s decision also mercifully ended the on-again off-again cycle that has characterized CECL preparation efforts since early 2020. One might think the decision would have resulted in relief. But with so much change in the world over the past few years, is it any wonder institutions are instead feeling change-saturated?  

Organizational change

CECL has been heralded as the most significant change to bank accounting ever, replacing 40+ years of accounting and regulatory oversight practices. But the new standard does much more than that. Implementing CECL has an effect on everything from executive and board strategic discussions to interdepartmental workflows, systems, and controls. The introduction of new methods, data elements, and financial assets has helped usher in new software, processes, and responsibilities that directly affect the work of many people in the organization. CECL isn’t just accounting—it’s organizational change. 

Change management

Change management best practices often focus on leading from optimism—typically leadership and an executive sponsor talk about opportunities and the business reasons for change. Some examples of what this might sound like as it relates to CECL might include, by converting to lifetime loss expectations, the institution will be better prepared to weather economic downturns; or, by evolving data and modeling precision, an institution’s understanding and measure of credit risk is enhanced, resulting in more strategic growth, pricing, and risk management. 

But leading from optimism is sometimes hard to do because it isn’t always motivating—especially when the change is mandated rather than chosen.  

Perhaps a more judiciously used tactic is to focus on the risk, or potential penalty, of not changing. In the case of CECL, examples might include, your external auditor not being able to sign-off on your financials (or significant delays in doing so), regulatory criticism, inefficient/ineffective processes, control issues, tired and frustrated staff. These examples expose the institution to all kinds of key risks: compliance, operational, strategic, and reputational, among them.

CECL success and change management

With so much riding on CECL implementation and adoption going well, some organizations may be at heightened risk simply because the effort is being compartmentalized—isolated within a department, or assigned to only one or two people. How effectively leadership connects CECL implementation with tenets of change management, how quickly they understand, then together embrace, promote, and facilitate the related changes affecting people and their work, may prove to be the key factor in achieving success beyond compliance.  

One important step leaders can take is to perform an impact assessment to understand who in the organization is being affected by the transition to CECL, and how. An example of this is below. Identifying the departments and functions that will need to be changed or updated with CECL adoption might expose critical overlaps and reveal important new or enhanced collaborations. Adding in the number of people represented by each group gives leaders insight into the extent of the impact across the institution. By better understanding how these different groups are affected, leaders can work together to more effectively prioritize, identify and remove roadblocks, and support peoples’ efforts longer term.           

 
No matter where your institution is currently in its CECL implementation journey, it is not too late to course-correct. Leadership—unified in priority, message, and understanding—can achieve the type of success that produces efficient sustainable practices, and increases employee resilience and engagement.

For more information, visit the CECL page on our website. If you would like specific answers to questions about your CECL implementation, please visit our Ask the Advisor page to submit your questions. For more tips on documenting your CECL adoption, stay tuned for our next article in the series, revisit past articles, or tune in to our CECL Radio podcast. You can also follow Susan Weber on LinkedIn.

Read this if you are a community bank.

The Federal Deposit Insurance Corporation (FDIC) recently issued its first quarter 2022 Quarterly Banking Profile. The report provides financial information based on Call Reports filed by 4,796 FDIC-insured commercial banks and savings institutions. The report also contains a section specific to community bank performance. In first quarter 2022, this section included the financial information of 4,353 FDIC-insured community banks. BerryDunn’s key takeaways from the report are as follows:

Community banks continue to feel the impact of shrinking net interest margins and inflation.

Community bank quarterly net income dropped to $7 billion in first quarter 2022, down $1.1 billion from a year ago. Lower net gains on loan sales and higher noninterest expenses offset growth in net interest income and lower provisions. Net income declined $581.3 million, or 7.7 percent from fourth quarter 2021 primarily because of lower noninterest income and higher noninterest expense.

Loan and lease balances continue to grow in first quarter 2022

Community banks saw a $21.5 billion increase in loan and lease balances from fourth quarter 2021. All major loan categories except commercial & industrial and agricultural production grew year over year, and 55.3 percent of community banks recorded annual loan growth. Total loan and lease balances increased $35.1 billion, or 2.1 percent, from one year ago. Excluding Paycheck Protection Program loans, annual total loan growth would have been 10.2 percent.

Community bank net interest margin (NIM) dropped to 3.11 percent due to strong earning asset growth.

Community bank NIM fell 15 basis points from the year-ago quarter and 10 basis points from fourth quarter 2021. Net interest income growth trailed the pace of earning asset growth. The yield on earning assets fell 28 basis points while the cost of funding earning assets fell 13 basis points from the year-ago quarter. The 0.24 percent average cost of funds was the lowest level on record since Quarterly Banking Profile data collection began in first quarter 1984. 

Community bank allowance for credit losses (ACL) to total loans remained higher than the pre-pandemic level at 1.28 percent, despite declining 4 basis points from the year-ago quarter.

NOTE: The above graph is for all FDIC-Insured Institutions, not just community banks.

The ACL as a percentage of loans 90 days or more past due or in nonaccrual status (coverage ratio) increased to a record high of 236.7 percent. The decline in noncurrent loan balances outpaced the decline in ACL, with the coverage ratio for community banks emerging 57.9 percentage points above the coverage ratio for noncommunity banks. 

The banking landscape continues to be one that is ever-evolving. With interest rates on the rise, banks will find their margins in flux once again. During this transition, banks should look for opportunities to increase loan growth and protect and enhance customer relationships. Inflation has also caused concern not only for banks but also for their customers. This is an opportune time for banks to work with their customers to navigate the current economic environment. Community banks, with their in-depth knowledge of their customers’ financial situations and the local economies served, are in a perfect position to build upon the trust that has already been developed with customers.

As always, please don’t hesitate to reach out to BerryDunn’s Financial Services team if you have any questions.

Read this if you are a leader in the healthcare industry.

BerryDunn recently held its first annual Healthcare Leadership Summit. Here are some highlights of the topics, presentations, and discussions of the day. 

Healthcare CFO survey results

The day began with an industry update where Connie Ouellette and Lisa Trundy-Whitten had the opportunity to present with Rob Culburt, Managing Director, Healthcare Advisory, The BDO Center for Healthcare Excellence & Innovation. Rob shared highlights from a recent survey of healthcare CFOs by The BDO Center for Healthcare Excellence & Innovation, while Connie and Lisa reflected on the similarities between study results and hospital and senior living clients.

It was no surprise the study found one of the most significant challenges CFOs are facing at both the national and local level is the sustained strain on healthcare systems amid the pandemic, and ongoing supply chain and workforce struggles. Additionally, providers are concerned about the upcoming reporting and regulation requirements. Also top of mind are the Provider Relief Fund (PRF) reporting requirements, as the requirements have been ambiguous and ever changing. There is also concern among survey respondents that a misinterpretation or reporting error could cause providers to have to pay back funding they received from PRF.

The BDO healthcare survey reported that 63% of the providers who responded to the survey are thriving, but 34% are just surviving. Out of those surveyed, 82% expect to be thriving in one year. You can view the full results of the survey here. 

Recruitment and retention in the current climate

Recruitment and retention of direct care providers are significant challenges within the senior living industry. Providers are facing workforce shortages that are forcing them to temporarily suspend admissions, take beds off line, and, in worst case scenarios close whole units or facilities. Sarah Olson, BerryDunn's Director of Recruiting and Bill Enck, Principal at BerryDunn discussed factors leading to the talent shortage, and shared creative short- and long-term recruitment and retention strategies to try.

Change management

The pandemic has forced many in healthcare to rethink how they operate their facilities. Employees have had to pivot on a moment’s notice, and in general do more with less. However, there are still initiatives that need to be undertaken and projects that must be completed in order for your facility to operate and remain financially viable. How do you manage the change associated with these projects? Can you manage the change without burning out your employees? Dan Vogt, BerryDunn Principal, and Boyd Chappell from Schoolcraft Memorial Hospital provided tips and strategies for managing change fatigue. 

Overall, the Leadership Healthcare Summit proved to be an informative and engaging event, and many new ideas and forward-looking strategies were shared to help enable providers to continue to weather current challenges and pistion themselves for success. For more in-depth information on these topics and others discussed, please visit our Healthcare Leadership Summit resources page. 

Read this if you are at a state Medicaid agency.

The Covid-19 Public Health Emergency (PHE) placed US state and territory Medicaid programs on the front line of reorganizing what healthcare looks like for millions of Medicaid enrollees. Each Medicaid program shifted automation and manual procedures in order to comply with and benefit from the increased federal funding in early 2020. With the PHE winding down, every Medicaid program must look at how to return to regular operations and unwind, or undo, the continuous coverage requirement temporarily put in place by the Centers for Medicare and Medicaid Service (CMS). BerryDunn has collaborated with Medicaid programs to identify best practices and consider new opportunities to implement rollback methods in an effort to lower risk during the unwinding period and beyond. 

New learning programs considered

Administrators who have been assessing their staff and operational readiness to support the expected influx of renewals, policy changes, and staffing changes are considering launching learning programs ahead of the unwinding efforts. Using this time to engage with staff has uncovered the need to redeploy fundamental learning programs to prepare for the anticipated high volume of two-years of renewals. Administrators have also begun to engage with community leaders and health plan organizations in ways that provide coordinated and complete communication to beneficiaries. Many programs have looked at expanding benefits within the guidelines of CMS, such as extending post-partum coverage to a full 12 months and increasing reasonable compatibility to a larger percentage, recognizing the economy has evolved since 2020.

Other outreach efforts

During the pandemic, many beneficiaries moved without notifying the Medicaid program of the address change. Proactive Medicaid programs are working directly with health programs and medical facilities to ensure the most updated addresses are captured, and are using public transportation advertisements, online website reminders, and email notifications to encourage beneficiaries to update addresses.

In other locations with a high rate of unemployment in specific industries, Medicaid programs are working with identified outreach partners like unions and industry associations to communicate messaging of Medicaid benefits. Thousands of employees may have lost full-time employment during the pandemic and have returned to work with reduced hours and less benefits. As a sign of changing times, some programs are employing social media campaigns to connect with existing and new enrollees. 

Medicaid programs across the states and territories are finding creative ways to reach impacted communities. Program administrators are organizing staff and systems to be well positioned to undo the effects of the temporary policies. The dismantling of the two-plus years of PHE is expected to be performed within a 12-month period. As administrators eagerly anticipate the announcement of an extension or the pending PHE unwinding start date, one thing is certain: US states and territories are preparing to support an extensive population of Medicaid beneficiaries post pandemic.

BerryDunn is partnering with many states and territories to help ensure a successful unwind of temporary services and return to normal operations. If you would like to discuss how BerryDunn can support your needs, contact the Medicaid consulting team.
 

Read this if you are a Police Executive, City/County Administrator, or elected government official responsible for a law enforcement agency. 

Are your officers overwhelmed with workload? Have you been asked to do more with less? Is your agency struggling with maintaining sworn staffing levels? Has your community been questioning why the police respond to things that might be more appropriately handled by others?

If you answered yes to one or more of these questions, your agency might benefit from a comprehensive analysis of your police call-for-service (CFS) response model. 

Increasing CFS workloads

Many police agencies in the US have been struggling with increasing CFS workloads, while simultaneously facing ever-tightening budgets and unprecedented attrition and vacancy rates. As a result of these challenges and national trends calling for police response reform, many police departments have started to ask a very simple question: “Is there a better way?”

Considering alternatives to police CFS response is not new. In fact, many agencies already use some form of CFS diversion, whether through a telephone response unit (TRU), online reporting, mobile apps, or the use of non-sworn personnel. What is different and new in the most recent discussion is the understanding that this conversation is not simply about providing these alternatives as possible options.

It is about considering fundamental changes to how police departments do business, including identifying collaboration opportunities with other organizations and in some cases outsourcing certain CFS types entirely.

Despite growing interest among police agencies in identifying alternatives to the traditional police CFS model, many have struggled to deliver an objective process that can produce meaningful results, and in some cases, suggested revisions have met with resistance from staff, elected officials, and community members.   

Best-practices approach to call for service response model

The best-practices approach to conducting an Essential CFS Evaluation should be one that is highly collaborative, but also expand beyond the walls of the police department. The 21st Century Policing Task Force final report explains:

Law enforcement agencies should work with community residents to identify problems and collaborate on implementing solutions that produce meaningful results for the community… and do things with residents in the co-production of public safety rather than doing things to or for them. 

Determining possible alternatives to traditional CFS police response requires substantial data collection and analysis to inform and guide outcomes and recommendations. It also requires a thorough and comprehensive process that considers:

• Legal mandates
• Immediate response needs
• Potential risk
• Workload volumes by CFS type
• Operational policies and training
• Alternative resources, whether or not they currently exist
• Community priorities and expectations
• Fiscal impacts

The cost of providing consistent and effective public safety services is one of the more critical reasons for considering CFS response alternatives. Although officer salaries vary by state, region, or department, the cost of staffing a non-sworn position is typically 40%-45% of the cost of a sworn officer.  

There is a common reason why the legal profession has attorneys and paralegals, the medical profession has doctors and physician’s assistants, and why many ambulance companies have moved to a paramedic and emergency medical technician (EMT) team, as opposed to staffing two paramedics in one ambulance. Cost is a driving force in these examples and the same circumstances are present in the law enforcement industry (among others). A well-trained non-sworn police staff member can handle a variety of CFS that do not require the presence of a sworn officer—likely at half the cost. Shifting the work burden from sworn to non-sworn personnel benefits officers by freeing them up to perform tasks that require an officer to respond, and it benefits the department and community by reducing costs. 

Beyond the issue of cost, there is also increasing conversation about the effectiveness and appropriateness of using police personnel to manage a variety of CFS types, including mental health incidents and those involving the unhoused, for example. Regardless of the CFS type, it is critical to use a process that involves influential participation by both providers and consumers. 

Making changes to the traditional police CFS response model is involved and it requires a thoughtful approach. BerryDunn has developed an Essential CFS Evaluation process that considers numerous critical factors to produce data that police staff, community and elected leaders can rely upon in making critical decisions about future public safety needs. 

If you are curious or have questions about our Essential CFS Evaluation process, our dedicated Justice & Public Safety team is available to discuss your organization’s needs.

Read this if you are a financial institution.

Choosing a method for estimating lifetime expected losses is a commitment. A commitment that signals, in spite of any other option, you’re certain this method is the right one for you—your segment, portfolio, and institution. While you might be able to support a change in method later, it is much more likely you’ll be living with this decision a good long while. So, how exactly does one know which method is the right one? Let’s take a few minutes to answer some frequently asked questions about selecting methods for CECL.

How many CECL methods are there?

This depends on who you ask. Section 326-20-30-3 of the standard names five (5) categories: discounted cash flow, loss-rate, roll-rate, probability of default, and aging schedule. Some categories, like loss-rate, have several methods. Additionally, some methods seem to be referred to by different names, giving people the impression that there are exponentially more options out there than there really are. With this in mind, I tend to think of two (2) broad categories, and seven (7) unique methods:  

• Loss-rate methods
  • Snapshot (open pool, static pool, cumulative loss rate)
  • Remaining Life and Weighted Average Remaining Maturity (WARM)
  • Vintage
     
• Other methods
  • Scaled CECL Allowance for Losses Estimator (SCALE) (option for banks with assets <$1 billion)
  • Discounted Cash Flow (DCF)
  • Probability of default 
  • Migration (roll rate, aging schedule)  

What’s the difference?

The loss-rate methods use actual historical net charge-off information in different ways to derive a loss rate that can then be used to calculate expected losses over the remaining life of a pool. In general, they do this by holding the mix of a group of loans constant (e.g., by year of origination) and then tracking net losses tied to that grouping over time. The “other” methods employ a variety of mathematical techniques and/or credit quality information to estimate expected lifetime losses. For a quick overview of each method and corresponding resources, access our CECL methodologies guide here.

How do I know which to use?

This is the CECL equivalent of the proverbial million-dollar question. Technically, any institution could use any one, or all of these methods. But there are considerations that make some of them a more or less likely fit. For example, if your institution has >$1 billion in assets, SCALE is not even an option for you, and you can cross it off the list. If you are not in a position to afford software, or lack the internal expertise to build a similar model internally, then discounted cash flow and probability of default methods would likely be extremely burdensome in the normal course of business. For that reason, you may need to cross those off your list. If you lack large pools with consistently diverse performance over time, then migration methods will be difficult to support. If you have a relatively stable loan mix, consistent credit culture, and a lot of reliable historical loss data—especially through multiple economic cycles—the loss-rate methods may be a good fit, with or without software. If your portfolio has undergone a lot of changes—products, underwriting standards, merger and acquisition activity—and/or there are significant gaps in key data that cannot be restored, then you might want to re-consider software and one of the “other” methods. 

What are the pros and cons of the various methods?

One pro of the loss-rate and SCALE methods is they have been shown to be manageable without software. Examples of all of these methods have been illustrated using Excel spreadsheets. The use of Excel is also potentially a con, given that more spreadsheets and, maybe more people, are likely going to be involved in computing the Allowance for Credit Losses (ACL). As a result, version control as well as validation of spreadsheet macros, inputs, formulas, math, and risk of accidentally overwriting or deleting values should be addressed. One pro of the discounted cash flow method is that it is a bottom-up approach, meaning each loan’s discounted cash flow (DCF) is computed and then rolled up to the segment level. Because of this, DCF can more easily handle mixed pools, e.g., loans of all vintages, sizes, terms, payment and amortization schedules, etc. A potential con of DCF is that it really requires software, staff trained to use the software appropriately, and an understanding of the vast array of choices, levers, and decisions that come with it.     

Does my choice of method affect my qualitative adjustment options?

How’s this for commitment: maybe. In general, I think it’s safe to say that CECL requires additional thought be given to the nature and degree of adjustments. This is especially true when you look at the combination of potential segmentation changes, new elements of the calculation, and the variety of methods now available. Consider the example of a bank using a loss-rate method and facing a potential economic downturn. If that bank has sufficient history and a relatively stable portfolio mix, credit culture, and geography, then it might elect to use a different time period—say, historical loss-rates observed from the last recession—rather than those more recently computed. In this case, the loss-rate method would already be using a recessionary experience. 

How then, would the bank approach additional qualitative adjustments for changing economic outlooks to ensure it is not layering (or double counting) reserve? Going back to the original “maybe” response, perhaps the answer is less about inherent conflicts between methods and qualitative adjustments. Rather, it’s about understanding that given your chosen method, you may be faced with even more decisions about if, where, and how much adjusting you are doing.

CECL adoption is required. Struggling to adopt isn’t. We can help.

No matter what stage of CECL readiness you are in, we can help you navigate the requirements as efficiently and effectively as possible. For more information, visit the CECL page on our website. If you would like specific answers to questions about your CECL implementation, please visit our Ask the Advisor page to submit your questions.

For more tips on documenting your CECL adoption, stay tuned for our next article in the series. You can also follow Susan Weber on LinkedIn.

Read this if you are a financial institution.

As you know by now, ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326), better known as the CECL standard, has already been implemented for some and will soon be implemented for all others (fiscal years beginning after December 15, 2022 to be exact). During your implementation process, the focus has likely been on your loan portfolio, and rightfully so, as CECL overhauls 40+ years of loan loss reserve practices. But, recall that the CECL standard applies to all financial instruments carried at amortized cost. So, it therefore includes held-to-maturity (HTM) debt securities. And, although not carried at amortized cost, the CECL standard also makes targeted enhancements to available-for-sale (AFS) debt securities. As if re-hauling your entire allowance methodology wasn’t enough! Before tearing out your hair because of another CECL-related change, let’s quickly review what is currently required for securities, and then focus on how this will change when you implement CECL.

Current US GAAP

Under current US generally accepted accounting principles (GAAP), direct write-downs on HTM and AFS debt securities are recorded when (1) a security’s fair value has declined below its amortized cost basis and (2) the impairment is deemed other-than-temporary. This assessment must be completed on an individual debt security basis. Providing a general allowance for unidentified impairment in a portfolio of securities is not appropriate. The previous amortized cost basis less the other-than-temporary impairment (OTTI) recognized in earnings becomes the new amortized cost basis and subsequent recoveries of OTTI may not be directly reversed into interest income. Rather, subsequent recoveries of credit losses must be accreted into interest income.

CECL: Held-to-maturity securities

Then comes along CECL  and changes everything. Once the CECL standard is implemented, expected losses on HTM debt securities will be recorded immediately through an allowance for credit loss (ACL) account, rather than as a direct write-down of the security’s cost basis. These securities should be evaluated for risk of loss over the life of the securities. Another key difference from current GAAP is that securities with similar risk characteristics will need to be assessed for credit losses collectively, or on a pool basis, not on an individual basis as currently prescribed. Also, contrary to current GAAP, since expected losses will be recorded through an ACL account, subsequent improvements in cash flow expectations will be immediately recognized through earnings via a reduction in the ACL account. CECL effectively eliminates the direct write-down method, with write-offs only occurring when the security, or a portion thereof, is deemed to be uncollectible. 

In practice, there may be some types of HTM debt securities that your institution believes have no risk of nonpayment and thus risk of loss is zero. An example may be a US Treasury debt security or possibly a debt security guaranteed by a government-sponsored enterprise, such as Ginnie Mae or Freddie Mac. In these instances, it is acceptable to conclude that no allowance on such securities is necessary. However, such determination should be documented and changes to the credit situation of these securities should be closely monitored.

Financial institutions that have already implemented CECL have appreciated its flexibility; however, just like anything else, there are challenges. One of the biggest questions that has risen is related to complexity, specifically from financial statement users in regards to the macroeconomic assumptions used in models. Another common challenge is comparability to competitors’ models and estimates. Each financial institution will likely have a different methodology when recording expected losses on HTM debt securities due to the judgment involved. These concerns are not unique to the ACL on HTM debt securities but are nonetheless concerns that will need to be addressed. A description of the methodology used to estimate the ACL, as well as a discussion of the factors that influenced management’s current estimate of expected losses must be disclosed in the financial statements. Therefore, management should ensure adequate information is provided to address financial statement users’ concerns.  

CECL: Available-for-sale securities

Upon CECL adoption, you are also expected to implement enhancements to existing practices related to AFS debt securities. Recall that AFS debt securities are recorded at fair value through accumulated other comprehensive income (AOCI). This will not change after adoption of the CECL standard. However, the concept of OTTI will no longer exist. Rather, if an AFS debt security’s fair value is lower than its amortized cost basis, any credit related loss will be recorded through an ACL account, rather than as a direct write-down to the security. This ACL account will be limited to the amount by which fair value is below the amortized cost basis of the security. Credit losses will be determined by comparing the present value of cash flows expected to be collected from the security with its amortized cost basis. Non-credit related changes in fair value will continue to be recorded through an investment contra account and other comprehensive income. So, on the balance sheet, AFS debt securities could have an ACL account and an unrealized gain/loss contra account. The financial institution will be responsible for determining if the decline in the value below amortized cost is the result of credit factors or other macroeconomic factors. In practice, the following flowchart may be helpful:

Although changes to debt securities may not be top of mind when working through CECL implementation, ensuring you reserve time to understand and assess the impact of these changes is important. Depending on the significance and composition of your institution’s debt security portfolio, these changes may have a significant impact on your financial institution’s financial statements from CECL adoption forward. For more information, visit the CECL page on our website. If you would like specific answers to questions about your CECL implementation, please visit our Ask the Advisor page to submit your questions.

Read this if you are at a state Medicaid agency. 

As the end of the Public Health Emergency becomes more likely, much attention has been paid to the looming coverage cliff as state Medicaid agencies re-determine eligibility for their programs. The impacts can be mitigated in part by planning and taking proactive steps.

In the unsettling initial days of the COVID-19 Public Health Emergency (PHE), the Centers for Medicare and Medicaid Service (CMS) temporarily increased federal matching funds for state Medicaid programs. In exchange, states would suspend redeterminations of enrollees’ eligibility for the duration of the PHE. 

For Medicaid, states were in effect prohibited from disenrolling an individual from Medicaid programs. The result, according to CMS data, is 14.8 million more people were enrolled in Medicaid as of late 2021 than before the pandemic, reaching a total of nearly 79 million Medicaid enrollees.  According to one estimate, the end of the PHE could bring a decline in the number of Medicaid enrollees by as many as 15 million. This number includes an estimated 8.7 million adults and 5.9 million children. 

Local and state government eligibility staff will need to review the submitted documents and determine if these members qualify for continued Medicaid coverage. The potential exists for members to lose coverage, due to factors such as having moved, not realizing their circumstances have otherwise changed, or being unable or unaware to return the required paperwork within appropriate timeframes.

State Medicaid agencies strive to maintain an equitable program while remaining trusted stewards of public funds. With a large base of beneficiaries, this change is expected to impact the community and the healthcare market, with broad implications for public health. Similarly, the federal requirement for continuous health coverage has also helped state Medicaid agencies by easing the strain on organizations during pandemic-related disruptions. 

For these reasons state Medicaid agencies may search for routes to limit the loss of coverage. This can be accomplished through finding policy levers to retain members, establishing routes to alternative forms of insurance, and mitigating the risk of coverage loss for members. 

Mitigating the likelihood of becoming uninsured

State Medicaid agencies can reduce the risk that members lose their coverage and become uninsured through a number of steps. 

• Designing comprehensive, multi-pronged, and targeted communication strategies. States can help Medicaid members understand the requirements and timelines required to maintain their coverage.
• Updating systems to automate and reduce administrative burden. Maximizing ex parte renewals through the use of existing data that is stored in integrated systems.
• Making key decisions early. States can minimize coverage loss by carefully planning the unwinding process and their approach to resuming Medicaid eligibility renewals.
• Coordinating with other forms of coverage. Confirm or design user-friendly pathways by which a member is transferred or referred to other alternatives like the Marketplace or CHIP.
• Leveraging their health plans. Particularly when it comes to coordinating outreach and updating member information. Managed care plans are also able to refer members who are losing coverage to other qualified health plans.

Policy levers for retaining members

States may consider reviewing emergency state plan amendments and appendix k amendments completed during the PHE to determine what flexibilities are possible to continue under existing authorities. At the same time, states should consider what other policy options may help retain coverage for existing members- for example:

• Adopt 12 months continuous eligibility. This can be done for children via a State Plan Amendment (SPA), for adults through an 1115 waiver, and for individuals enrolled in BHP (via BHP Blueprint revision) 
• Establish 12 months of postpartum coverage. This can be done through several paths, including SPAs 
• Review operational policy for efficiencies. For example, a State could consider modifying the frequency of periodic data matching 

Next steps

The US Department of Health and Human Service has previously indicated its intention to provide notification to states of the end of the PHE 60 days before its scheduled end. The PHE was renewed in April 2022, and as of this writing will last until mid-July, meaning enrollees could lose Medicaid coverage as soon as August 1. The enhanced FMAP and the Maintenance of Eligibility (MOE) requirements are in place until the end of the quarter in which the PHE ends. In the case of a July 2022 end date to the PHE, the enhanced FMAP would last through September 30, 2022. 

Regardless, Medicaid agencies will need to begin reviewing all enrollees’ eligibility, performing outreach, and designing system updates this summer. In terms of next steps, states should consider the following:

• Evaluate your program and identify initiatives to prioritize in the coming year. Ask your CMS contact about the latest applicable guidance. 
• Develop Advanced Planning Documents (APDs) to help fund technology needs for initiatives, along with training your SMA team and providers. 
• Implement a communications management approach to engage stakeholders, and inform affected Medicaid members.
• Marshal project management resources and develop a realistic and achievable roadmap to success.  
• Explore agency contracting vehicles, cooperative contracts, and other procurements tools. 

We’re here to help. If you have more questions or want to have an in-depth conversation about your specific situation, please contact the Medicaid consulting team.

Read this if you are at a financial institution.

While documentation of your CECL implementation and ongoing practices is essential to a successful outcome, it can sometimes feel like a very tall order when you are building a new methodology from the ground up. It may help to think of your CECL documentation as your methodology blueprint. While others will want to see it, you really need it to ensure that what you are building is well-designed, structurally sound, appropriately supported, and will hold up to subsequent “renovations” (model changes or tweaks). To help you focus on what’s essential, consider these documentation tips:

Getting started

Like any good architect, you need to understand the expectations for your design—what auditors and regulators want to see in your documentation. Two resources that can really help are the AICPA Practice Aid: Allowance for credit losses-audit considerations¹, and the Interagency Supervisory Guidance on Model Risk Management². One way to actively use these guides is to take note of the various section/subject headers and the key points, ideas, and questions highlighted within each, and turn that into your documentation checklist. You’ll also want to think strategically about where to keep the working document, who needs access to it, and how to maintain version control. It is also a good idea to decide up-front how you will reference, catalog, and store the materials (e.g., data files, test results, analyses, committee minutes, presentations, approvals, etc.) that helped you make and capture final decisions. You can download our CECL Documentation checklist now.   

What to watch out for

What’s new under CECL are areas requiring documentation (e.g., broader scope of “financial assets,” prepayments, forecasts, reversion, etc.). But watch out for elements that seem familiar—they may now have a new twist (e.g., segmentation, external data, Q factors, etc.). It’s a good idea to challenge any documentation from the past that you feel could be re-purposed or “rolled into” your CECL documentation. Be prepared also to spend time explaining or customizing vendor-provided documents (e.g., model design and development, data analysis memos, software procedures, etc.). 

While this material can give you a running start, they will not on their own satisfy auditor and regulator expectations. Ultimately, your documentation will need to reflect your own understanding and conclusions: how you considered, challenged, and got comfortable with the vendor’s work; what validations and testing you did over that work, and how you’ve translated this into policies and procedures appropriate for your institution’s operations, workflows, governance, and controls. For more information on making the vendor decision, and for suggestions of vendor selection criteria, read our previous article “CECL Readiness: Vendor or no vendor?” 

Point of view

It is human nature, especially whenever entering new territory, to want to know how others are approaching the task at hand. Related to CECL, networking, joining peer discussion groups, researching what and how those who have already adopted CECL are disclosing, are all great ways to see possibilities, learn, and gain perspective. When it comes to CECL documentation, however, the most important point of view to communicate is that of your institution’s management. Consider the difference in these two documentation approaches: (a) we looked at what others are doing, this is what most of them seem to be doing, so we are too; or (b) this is what we did and why we feel this decision is the best for our portfolio/risk profile; as part of our decision-making process, we did this type of benchmarking and discovered this. Example b is stronger documentation: your point of view is the primary focus, making it clear you reached your own conclusions. 

Other elements for CECL documentation

Documenting your CECL implementation, methodology, and model details is critical, but not the only documentation expected as you transition to CECL. It has been said that CECL is a much more enterprise-wide methodology, meaning that some of the model decisions or inputs may require you use data and assumptions traditionally controlled in other departments and for other purposes. One common example of this is prepayments. Up to this point, prepayment data may have been something between management and a vendor and used for management discussion and planning, but not necessarily validated, tested, or controlled for in the same way as your loss model calculations. Under CECL, this changes specifically because it is now an input into the loss estimate that lands in your financial statements. As a result, prepayments would be subject to, for example, “accuracy and completeness” considerations, among others (for more information on these expectations, refer to our earlier articles on data and segmentation). Prepayments is just one example, but does illustrate how CECL adoption will likely trigger updates to policies, procedures, governance, and controls across multiple areas of the organization.    

One final note: There are some new financial statement disclosures required with CECL adoption. Beyond those, there may be other CECL-related information either you want to share, or your audit/tax firm recommends be disclosed. Consulting with your auditor at least a quarter prior to adoption will help make sure you aren’t scrambling last minute to draft new language or tables.  

Struggling with CECL documentation or other elements of CECL? 

No matter what stage of CECL readiness you are in, we can help you navigate the requirements as efficiently and effectively as possible. For more information, visit the CECL page on our website. If you would like specific answers to questions about your CECL implementation, please visit our Ask the Advisor page to submit your questions.

For more tips on documenting your CECL adoption, stay tuned for our next article in the series. You can also follow Susan Weber on LinkedIn.

¹You can find the AICPA Practice Aid here.
²The interagency guidance was released as OCC Bulletin 2011-12, FRB SR 11-7, and as FDIC FIL 22-2017