Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Challenges and lessons learned


Louisiana officials note that their approach is not static, and the state continues to make changes. They highlight that retention improvement is a continual process with significant potential for enhanced outcomes and greater efficiencies for both clients and program staff.

State officials believe that their approach to renewal has achieved administrative savings by substantially reducing the need for caseworker involvement. On the other hand, state officials report that the thoughtful and careful implementation of innovative reforms requires significant effort. That effort was aided by several years of support from the Robert Wood Johnson Foundation’s “Maximizing Enrollment” national program (“MaxEnroll”).

Louisiana typically involves, in addition to state officials, front-line caseworkers in helping shape the details of implementing innovative policies. The state often tests new approaches on a small scale before implementing them statewide. At the same time, an attitude of experimentation and willingness to make mistakes and learn from them is inculcated at all levels of the agency, from front-line caseworkers to leading state officials. This kind of agency culture has been critically important to the state’s success, and it may not be simple to replicate it elsewhere.

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