Content by Keyword: Integration of Health and Human Services

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About the authors and acknowledgments

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . About the authors and acknowledgments

Fredric Blavin, Stan Dorn, and Jay Dev are, respectively, a Senior Research Associate, Senior Fellow, and Research Assistant at the Urban Institute’s Health Policy Center. The authors are grateful to ASPE for supporting this research and particularly appreciative of the assistance and substantive guidance furnished by our project officer, Alana
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Conclusion

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Conclusion

Structuring the interface between health and human services programs, in the context of ACA implementation, is likely to involve considerable experimentation and learning over time. Fortunately, much research has already identified many factors that influence, sometimes in surprising ways, consumers’ responses to the options they encounter. Base
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Overarching issues

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Overarching issues

Several issues arise in all the above settings for raising the SNAP question when people apply for health coverage. First, Marketplaces need to decide which consumers will be presented with the option of seeking SNAP. In theory, a Marketplace could offer all applicants for health coverage the opportunity to connect with SNAP. In practice, it wil
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3. Presenting SNAP enrollment opportunities when

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . 3. Presenting SNAP enrollment opportunities when health coverage is being renewed

A third approach would raise the SNAP issue as Medicaid or Marketplace subsidy eligibility is being renewed. At this point, consumers are likely to experience much less cognitive and choice overload than during the initial coverage application.
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2. Presenting SNAP enrollment opportunities

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . 2. Presenting SNAP enrollment opportunities before the end of the initial application for health coverage

A second strategy would raise the SNAP issue before the initial health enrollment process is complete. 78 For example, a consumer who appears likely to qualify for human services programs could be given the option to complete either a health-only application or a multi-program application that requests the information needed by both SNAP and heal
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1. Presenting SNAP enrollment opportunities after

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . 1. Presenting SNAP enrollment opportunities after the initial enrollment into health coverage is complete

One possible approach would delay questions about SNAP until after the health application process is complete. This would ensure that SNAP questions pose no barrier to enrollment into health coverage, thereby meeting the requirements of the CMS guidance described earlier. It would also avoid burdening state health programs with the need to modify
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Implications for facilitating SNAP enrollment

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Implications for facilitating SNAP enrollment

The above analysis suggests that the process of enrolling into subsidized Marketplace coverage is likely to deplete the cognitive resources of many who go through the process. Asking such consumers to then begin the process of enrolling into SNAP, an entirely new benefit program, could prove challenging.
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Research findings

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Research findings

This report does not analyze how Marketplaces and Medicaid programs can best structure the application and health plan choice process. Rather, we focus on that process’s cognitive demands to understand the consumer’s mindset when faced with the additional questions posed by possible SNAP enrollment.
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After people have qualified for insurance

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . After people have qualified for insurance affordability programs, what else must they do to apply for SNAP?

Depending on the individual’s situation, the following steps may be required:
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Context #2: Helping applicants for health

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Context #2: Helping applicants for health coverage connect to human services programs

This second context focuses on how potentially eligible consumers could be connected to the SNAP program while they are applying for health insurance at the Marketplace. Here, we draw on behavioral economics findings related to cognitive psychology and consumer choice. The discussion emphasizes online applications for health coverage, but much of
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Implications for targeted enrollment into Medicaid

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Implications for targeted enrollment into Medicaid

In sum, the literature described above finds that apparently modest procedural burdens—the requirement to complete a form or even check a box, for example—can have a substantial impact on program participation, as can eliminating such burdens by completing forms on consumers’ behalf. This has important implications for implementation of targ
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Eliminating paperwork by completing it on

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Eliminating paperwork by completing it on consumers’ behalf

A randomized, controlled experiment tested the impact of tax preparers actually filing SNAP applications for eligible consumers, compared to completing applications and providing instructions about how and where the consumers could file them. Low-income clients at H&R Block offices were provided information about the monthly SNAP benefits for
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Organ donation check-boxes and opt-outs

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Organ donation check-boxes and opt-outs

Different countries take different approaches to organ donation. Johnson and colleagues reported that, in six out of the seven European countries where organ donation takes place unless people object by mailing a form or making a telephone call, at least 98 percent of decedents effectively consented to have their organs donated.
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SNAP check-boxes

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . SNAP check-boxes

Louisiana’s experience illustrates the impact of requiring families to check a simple opt-in box before their children can obtain expedited Medicaid coverage based on SNAP receipt. Since February 2010, Louisiana has implemented Express Lane Eligibility (ELE) to qualify children as financially eligible for Medicaid using findings already made by
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Retirement savings

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Retirement savings

In theory, whether someone must complete a simple form to enroll in a retirement savings plan or to opt out of enrollment should not have a major impact on participation levels. A minor, short-term inconvenience hardly seems commensurate with the long-term benefits of accumulating retirement savings. In reality, considerable research shows that su
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Research findings

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Research findings

For this first operational context, we focus on the behavioral literature involving many people’s aversion to the completion of paperwork. This can take the form of procrastination or failing to submit required forms. As a result, whatever arrangement goes into effect by default—that is, in the absence of consumer action—winds up being widel
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Context #1: Using human services data to qualify

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Context #1: Using human services data to qualify consumers for Medicaid

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Insights on take-up from behavioral economics

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Insights on take-up from behavioral economics

Neoclassical economics assumes that people have rational, fairly consistent preferences over time. Each person seeks to maximize his or her overall well-being by obtaining, understanding, and rationally acting upon available information. In contrast, behavioral economics focuses on human limitations, empirically testing the ways in which human beh
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Insights on take-up from neoclassical economics

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Insights on take-up from neoclassical economics

Expected utility maximization theory can help explain why many eligible individuals do not take up seemingly free public benefits for which they qualify. Two major literature reviews analyze the impact of multiple factors on participation levels in many different programs.
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Background

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Background

Many eligible people do not participate in SNAP and Medicaid.

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Form Approved OMB# 0990-0379 Exp. Date 9/30/2020