Content by Keyword: Medicaid

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Overview

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

In March 2011, Minnesota expanded Medicaid coverage to childless adults with incomes up to 75 percent FPL. This represented an “early expansion” of the ACA’s increased Medicaid eligibility for adults. To quickly enroll eligible consumers, the state used two primary strategies. First, the Minnesota Department of Health Services (DHS) collabor
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Minnesota: coordinated outreach and enrollment

Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Minnesota: coordinated outreach and enrollment

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Third case study area: Multi-program outreach and

Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Third case study area: Multi-program outreach and enrollment

This section focuses on practices that involve outreach and enrollment across multiple health and non-health programs. Examples include coordinated efforts to help individuals receive services from multiple programs or efforts to target beneficiaries of one program for outreach efforts from another program. Likewise, multi-program coordination may
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Challenges and lessons learned

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

Building the eREP system was a large project, involving many different programs and interfaces. Utah officials report that, as with many such projects, it was complex to integrate multiple systems. However, coordination and communication among state program staff and IT staff helped overcome these difficulties.
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Results

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

For 2010, the first year eREP was fully operational, the caseload that could be handled by a single worker increased by 53 percent, compared to 2008. From 2009 to 2010, total caseloads increased by close to 19,000 cases, or 12.3 percent, while operational costs decreased by $7.3 million, or 9.6 percent. 55
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Description

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

A 2001 review of Utah’s previous eligibility system found that it met only 52 percent of business needs, eligibility determinations varied based on the worker’s expertise, and the system provided no online access for customers. 47 Other factors drove policymakers to revise the state’s eligibility system, including a prior history of inconsi
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Overview

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

In 2010, Utah launched the Electronic Resource and Eligibility Product (eREP) system. The eREP system replaced the state’s 20-year-old eligibility system and was designed to both determine eligibility and issue benefits for more than 60 federal and state programs. 46
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Utah: Electronic Resource and Eligibility Product

Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. Utah: Electronic Resource and Eligibility Product (eREP)

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Second case study area: Coordinating

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.
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Challenges and lessons learned

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

One key to CAPs’ simplification of the enrollment process is the replacement of individualized with more standardized benefit determinations. Although states seek to set the latter as close to the former as possible, some imprecision is inevitable. The presumptions underlying CAP are that most participants would trade a few dollars in benefits f
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Results

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

South Carolina began the first CAP in 1995. This state raised SNAP participation among SSI recipients from 38 percent in 1994 to 50 percent in 1998. During this same time period, SNAP participation among SSI recipients nationally decreased, from 42 percent to 38 percent. South Carolina’s efforts led to more than 8,500 seniors and people with dis
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Description

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

Low rates of SNAP participation among the elderly have posed a longstanding problem.
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Overview

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

Combined Application Projects (CAPs) involve partnerships between the Social Security Administration (SSA), state agencies, and FNS that simplify the SNAP application process for SSI recipients who live alone or with a spouse who also receives SSI. CAPs utilize a SNAP law permitting households to be treated as categorically eligible for SNAP if al
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SNAP/SSI Combined Application Projects

Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. SNAP/SSI Combined Application Projects

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Challenges and lessons learned

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

The state had to overcome various challenges to implement ELE effectively. As with much interagency collaboration, South Carolina’s DHHS and DSS offices had to resolve differences in data collection methods before they could share information efficiently. DHHS also needed to decide how to handle cases that did not easily fit into the automated E
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Results

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

Between September 2012 and June 2013, more than 92,000 previously uncovered children enrolled in Medicaid through ELE in South Carolina. 20 Compared to the state’s FY 2012 enrollment of 607,681 children, 21 ELE enrollees represented a 15 percent increase in coverage.
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Description

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

In South Carolina, children in low-income families with incomes up to 200 percent of the Federal Poverty Level (FPL) have long qualified for Medicaid. As of 2011, 19 percent of children in this income band were uninsured; only five states had a higher percentage of low-income children without coverage. 16
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Overview

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

As described above, ELE lets state Medicaid and CHIP programs enroll and renew children based on the findings of other public agencies. In 2011, South Carolina adopted ELE, qualifying children for Medicaid based on their receipt of SNAP or TANF. Unlike Louisiana, which started with enrollment, South Carolina began by using ELE for renewals. The st
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South Carolina: Express Lane Eligibility

Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. South Carolina: Express Lane Eligibility

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Challenges and lessons learned

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

State officials overcame several challenges. ELE implementation required considerable time and patience from state staff– especially with two different agencies administering Medicaid and SNAP. States with a single agency administering both programs would probably have had an easier time implementing this ELE approach. State policymakers also no

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