Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Second case study area: Coordinating administration of multiple programs


This section focuses on the coordinated administration of multiple health and non-health programs. Such efforts can include synchronized redeterminations, through which information provided to renew eligibility for one program automatically reestablishes eligibility for other programs; coordinated systems of consumer communications that prevent multiple programs from sending redundant or conflicting messages to their common clients; and joint procurement or development of eligibility technology, including on-line application systems, electronic case records, eligibility data warehouses, enterprise service buses (which could include shared rules engines and data-matching hubs), upgraded automatic voice response systems, technology for interacting with customers’ mobile phones (including to permit customers to  photograph pay stubs and other documentation and furnish such information over the internet), and similar steps that could potentially qualify for enhanced federal funding. As noted earlier, when such investments develop systems that benefit Medicaid along with human services programs and are completed by December 31, 2015, they can potentially qualify for 90 percent federal Medicaid funding, without a need for human services programs to share the development costs.45

As with the previously described strategies, the benefits of coordinated administration can be realized by both agency staff and clients. Clients of several programs can provide information once rather than multiple times, simplifying application and renewal procedures. Coordinated administration can also lessen burdens on caseworkers and reduce administrative costs—an appealing result during the recent economic slowdown, when caseloads increased and state-funded caseworker staffing levels remained stagnant or fell.

Here, we describe Utah’s automated eligibility determination system, which has achieved remarkable efficiencies serving multiple health and human services programs. Appendix A provides briefer summaries of other examples in this category.

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