Ideas and Inspirations from CMS Eligibility Conference

I missed last week’s CMS conference, Medicaid/CHIP Eligibility and Enrollment: On the Road to 2014, so I checked-in with my colleague, Alice Weiss, who was there to get the download. Alice highlighted five key “ideas and inspirations” for today and 2014 that she thought were worth sharing. Feel free to share your ideas and inspirations from the meeting in the comments section.
#1 Give new technology—like Echats, texting, and YouTube— a try.
States are continuing to take advantage of technology to increase outreach and enrollment. Recent research from Pew shows that the digital divide is in decline and states are finding that email and cell phones communication is working better than ever. In addition to online applications, and notices by text message, Utah is piloting an “echat” that allows people trying to fill out online benefit applications to “chat” with a caseworker in real time through instant messaging. So far, in just two months, Utah says that residents have initiated more than 4,000 chats. Utah is also exploring using text messages for benefit notices. Virginia is using free cell phone ring tones, a YouTube video, and a unique website to engage teens. Tune into the NASHPwebinar on alternative signatures on September 30 at 3 PM ET.
#2 Take advantage of the Social Security match for citizenship and identity.
States shared success stories about using the Social Security data match option for verifying citizenship and identity. States are reporting a 94% match rate with this system and cost savings as well. California estimated that the data match is saving $30 million annually, and Washington reported that it saved $600,000 since implementation in February 2010. Approximately 20 states have not yet taken up this option, even though these types of interfaces with the Social Security database often exist for other purposes. PPACA will require that all new applicants for public coverage or subsidies be screened for citizenship and documentation identification, so establishing this process is an important investment for the future. A webinar on this topic and additional resources are available here.
#3 Tailor outreach to target populations.
Mike Perry from Lake Research Partners and Alison Betty from GMMB presented recent research that found that people value and want to enroll in Medicaid and CHIP, but that the enrollment process is often a barrier to participation. They talked about key messages to target three groups of eligible populations states are now struggling to reach:
Higher income people – Find newly unemployed people in unemployment insurance offices, use new messages, these people do not know Medicaid and CHIP and will not identify the programs themselves eligible for what they perceive as a “welfare” program.
Latinos and immigrants – Start with the message that the parents’ citizenship will not be checked, and focus the message on the availability of coverage for eligible children.
Adolescents – Use new ideas and ways of communicating, like branding being done in Virginia. To see Virginia’s FAMIS teen website, click here.
#4 Plug the “hole in the bucket.” Save money by focusing on retention.
Don Gregory, Louisiana’s Medicaid Director, pitched focusing on renewing coverage for eligible individuals as a way for states to preserve and protect the states’ investment in identifying and enrolling people in a program. Ten years ago, Louisiana was losing more than 6,000 kids in a single month, eroding all their investment in outreach and enrollment. Since then, Louisiana has shifted resources to focus on retaining eligible children at renewal and found new efficiencies, saving money and speeding up the process. One example is their “administrative renewal” process. The state identifies families eligible for coverage continuously year after year and takes them out of the renewal process altogether after sending a notice that the family should alert the state if their situation changes. They also use “ex parte” renewals where caseworkers use existing data in other benefits databases to automatically verify income and other information and continue coverage without interruption. By streamlining renewals, Louisiana has eliminated busywork and preserved caseworkers limited time for more complex cases.
#5 Culture change matters.
Yvette Woodland from the Utah Department of Workforce Services reminded states as they focus on system change in eligibility and enrollment, that they should not forget that changing worker culture is also important. For more discussion on culture change, see pages 31-32 of this Maximizing Enrollment for Kids report. See also this report from the Southern Institute.
Please feel free to contact Alice Weiss, aweiss@oldsite.nashp.org with any questions about the CMS eligibility conference.
Best, Sonya
Alice Weiss, Program Director, NASHP