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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology

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What are States doing to address enrollment and retention issues using health IT?

States have employed a number of strategies using health IT to increase enrollment and retention of children within public insurance programs. The Kaiser Family Foundation published a recent report entitled Challenges of Providing Health Coverage for Children and Parents in a Recession (PDF - 1.5MB) go to exit disclaimer outlining current State activities within public insurance enrollment and retention. States' strategies include:

  • Streamlining the application process - creating electronic, Web-based applications and combining social service applications.
  • Automating the renewal process - electronically monitoring recipients' current status to facilitate faster renewal and re-enrollment.
  • Electronically verifying eligibility data - creating shared databases used to facilitate information verification among different and disparate agencies. An example includes Massachusetts' deployment of the Electronic Verification of Vital Events (EVVE) system which provides instant certification of birth records to State and Federal agencies requiring proof of vital events and to assist eligibility determinations for public programs or benefits.
  • Automating outreach activities - leveraging existing information to target children who are likely to be eligible for public insurance programs. South Carolina uses its integrated data system (PDF - 584 KB) go to exit disclaimer to map addresses of uninsured children visiting emergency rooms and then targets areas of high usage with outreach and advertising designed to increase public insurance enrollment.

States have begun to create health IT systems to streamline application and enrollment and automate renewal processes. In California, Health-e-App provides an online application for Healthy Families and Medi-Cal for Children programs. One-e-App go to exit disclaimer also is a Web-based, online application for Medicaid and CHIP which, in addition, provides a system to link individuals and families to a range of publicly funded social service programs. Pennsylvania offers an application system dubbed COMPASS, which provides a bridge between Medicaid, CHIP, and the State's program for low-income adults called adultBasic.go to exit disclaimer COMPASS provides automatic transfer of information between enrollment systems to assist the program reassignment process. The State of Washington go to exit disclaimeris using food stamp recertification information for Medicaid re-determinations. With this information, Washington Medicaid information is updated and a child's eligibility automatically extended. The process of using information the State already has to automate renewal is sometimes referred to as "administrative renewal."
Thirteen States confirm applicant income information using Social Security or State Department of Labor data rather than requiring paper check stubs. The electronic verification of eligibility data, such as income level, is also referred to as "administrative verification." This site go to exit disclaimer has information on States' use of administrative verification.

States are also using health IT to augment outreach activities. For example, Oklahoma established an enrollment information website go to exit disclaimer and provides computer kiosks in community locations. In Florida periodic checks are run on food stamp recipients and those households with children not enrolled in Medicaid are sent a letter informing the parent or guardian of their child's possible eligibility for public insurance coverage. The Florida and Oklahoma examples are detailed in a recent report by The Children's Partnership and The Kaiser Commission on Medicaid and the Uninsured (PDF - 584 KB)go to exit disclaimer.

Additional Outreach Examples:

Additional Enrollment and Retention Example:

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