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.
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Results
From October 2012 through September 2013, the most recent 12 months for which data are available, 76 percent of children’s renewals were based on data matches, either through ELE (20 percent), administrative renewal (36 percent), or ex parte renewal (20 percent) (fig. 1). Of the remainder, most (15 percent) were renewed by telephone. Only 4 perc
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Description
Louisiana’s approach to renewal is part of the state’s broader approach to streamlined eligibility determination for children’s Medicaid and CHIP, which encompasses initial applications as well as renewal.
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Overview
Louisiana has been a national leader in streamlining eligibility determination for health coverage. A particularly promising set of practices involves renewing children’s health coverage, including a heavy emphasis on data matching with human services programs and other sources of information relevant to eligibility.
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. First case study area: Streamlining eligibility determination for one program based on data linkages with another program
This first section focuses on practices that have shown progress in streamlining eligibility determination for one program based on data linkages with another program. This can take place across both health and non-health programs. Such strategies can involve, for example, “deeming” eligibility for one program based on decisions made by anothe
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Methodology
Case study selection
The case selection process was a highly collaborative effort between Urban Institute staff and ASPE. We decided to seek practices that—
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Introduction
For many years, state and federal officials have grappled with the challenge of effectively integrating and coordinating the operation of multiple health and human services programs that serve overlapping populations. Such efforts can yield many gains. When one program determines eligibility based on the work already done by another program, it si
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Executive Summary
It is not easy to effectively integrate and coordinate the operation of multiple health and human services programs that serve overlapping populations, but such efforts can yield significant gains. When one program determines eligibility based on the work already done by another program, public agencies can save administrative costs and streamline
Among consumers under age 65 who will be newly eligible for health programs under the Affordable Care Act, the percentage who receive or qualify for various human services programs
Source : TRIM3, HIPSM 2012. Notes: Assumes that all states expand Medicaid eligibility for adults to 138 percent FPL. Eligibility for Medicaid and CHIP includes children’s pre-ACA categories above 138 percent FPL. Proxy measure for newly eligible adults includes childless adults up to 138 percent FPL and parents with incomes between 63 percent
Among consumers under age 65 who will be newly eligible for health programs under the Affordable Care Act, the percentage who receive or qualify for various human services programs
Source : TRIM3, HIPSM 2012. Notes: Assumes that all states expand Medicaid eligibility for adults to 138 percent FPL. Eligibility for Medicaid and CHIP includes children’s pre-ACA categories above 138 percent FPL. Proxy measure for newly eligible adults includes childless adults up to 138 percent FPL and parents with incomes between 63 percent
CSV
Overlapping Eligibility and Enrollment: Human Services and Health Programs Under the Affordable Care Act
This report presents information on overlaps in eligible and participating populations in various health and human services programs, and identifies three main human services programs – the Supplemental Nutrition Assistance Program (SNAP), the Low Income Home Energy Assistance Program (LIHEAP), and the Earned Income Tax Credit (EITC) – as havi
rpt_integrationproject.pdf
Opportunities under the Affordable Care Act for Human Services Programs to Modernize Eligibility Systems and Expedite Eligibility Determination
This paper summarizes opportunities for states to utilize time-limited federal cost-sharing to modernize human services program eligibility systems and to use data from health programs to streamline eligibility determination for human services.
ib_ModernizeEligibilitySystems.pdf
Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act
This paper examines opportunities to apply findings from behavioral economics and decision-making theory to two specific health/human services program interaction contexts: using targeted enrollment strategies to get SNAP recipients into Medicaid, and encouraging individuals seeking health insurance through state marketplaces to apply for SNAP.
rpt_BehavioralEconomics.pdf
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act
This paper presents findings from case studies of selected state-level integration and coordination approaches under the ACA and identifies areas of notable success or potential which may be of interest to other states.
rpt_PromissingPractices.pdf
