As Figure III.6 shows, ELE programs have generated a range of net costs and savings. The ELE programs in Alabama and Louisiana yielded large net savings, driven by the staff time saved through processing relatively efficient ELE applications and renewals instead of traditional applications and renewals.
In Maryland, ELE did not save any staff time that would offset new mailing costs. In New Jersey, ELE has added costs (for new mailings) but it has not generated any savings to offset those costs. The time savings from more efficient ELE application processing in New Jersey is absorbed by the state’s third-party administrator. The existing contract was not revised to account for either an increased number of applications resulting from ELE or the increased simplicity of those applications relative to traditional applications.
Programs in Oregon and Iowa Medicaid were essentially cost neutral from an administrative perspective. Mailing costs and the time spent processing unsuccessful ELE applications balanced time savings from successful ELE applications.
Notably, in no case did program staff describe ELE as directly resulting in the need to hire additional staff or the ability to eliminate staff positions. Any time savings resulting from ELE were instead used to address other program needs. For example, Louisiana saved about 69,000 staff hours per year from ELE—the equivalent of 33 full-time positions—but it used the savings to make up for staffing reductions caused by state budget cuts. Staff described ELE as enabling
Figure III.6. Net Annual Administrative Savings and (Costs) from ELE
Medicaid to stay on top of its workload in the face of reduced staffing. Similarly, Alabama noted that staff time saved through ELE may have enabled staff to process the traditional applications more quickly than would otherwise have been possible.