Takeaways from a State-to-State Exchange on Streamlining Enrollment

Last week, I had the good fortune to attend a NASHP event in Boston, MA. Officials from eight states who participate in the Robert Wood Johnson Foundation-supported Maximizing Enrollmentinitiative came together to learn from one another about their ongoing efforts to streamline enrollment in health coverage programs, and prepare for implementation of new enrollment systems for individuals who will be newly eligible for public and publicly subsidized programs in 2014. Many of the discussions involved ways that states can use technology and systems solutions to minimize unnecessary paper-based processes.

• Howard Caplan, Director of the MassHealth Virtual Gateway, described Massachusetts’ Virtual Gateway, a centralized portal for health and human services eligibility determinations. The Virtual Gateway allows intake workers, application
  assistors, and healthcare providers to enter eligibility information for clients that is then routed to appropriate back-end systems. Individuals can also use the system to screen for eligibility for a range of public benefits. Caplan encouraged states to borrow from each other in developing these interfaces. In addition to the Virtual Gateway in Massachusetts, other systems to consider as models include ACCESS in Wisconsin, COMPASS developed in Pennsylvania, and UtahClicks.
• Lynn Andrews, Director of Change Management for MassHealth Operations, explained the state’s plans for moving from paper documentation to digital images.  The Electronic Document Management initiative will scan paper documentation in a central office and make scanned images available to caseworkers electronically on the day they are received. Scanned images allow workers to access information more efficiently and enhance customer service since documents are more easily tracked. Andrews highlighted the attitude shift for eligibility workers whose work environment changed dramatically. Wisconsin experienced a similar shift when moving from face-to-face to electronic applications. Both states emphasized the importance of helping eligibility staff adjust to the culture changes that accompany major eligibility process changes.
• John Bogasky, a consultant with Advancier LLC, outlined key considerations for state leaders of IT system change initiatives. When contemplating IT system changes, he advised states to “begin by defining what you want, rather than worrying about what your current system can’t do.” Participants agreed that the ACA provides a unique opportunity for large-scale system upgrades that is rarely seen, but that the timelines are challenging. In New York, the state, with support from an Early Innovator Grant, plans to build on its MMIS infrastructure to have ACA-required components in place by 2014, and to keep making improvements over time.

Does your state have materials to share about technology and systems solutions to minimize unnecessary paper-based processes? Please share them with us and other states by posting them on your state page at State Refor(u)m. To engage in a cross-state discussion about thismilestone, visit State Refor(u)m’s national discussion page.