Pennsylvania:
Streamlined Enrollment & Renewal through Technology
Background/History
In the early 1990's, a lawsuit on EPSDT[1] service delivery in Pennsylvania brought advocacy groups and government staff together to develop strategies for improving access to health care. Because Medicaid and the then-state-funded Children's Health Insurance Program (CHIP) were housed in different agencies (the former in the Department of Public Welfare and the latter in the Insurance Department), the need for joint efforts and strategic alignment of policies and practices was pronounced.
Following the launch of the federal State Children's Health Insurance Program (SCHIP) in 1998, these working sessions resulted in development of a key product: a joint Medicaid and CHIP application that was literacy tested and more user friendly. Additional Medicaid and CHIP enrollment and renewal policies and practices used in Pennsylvania include:
- 12 months continuous eligibility for CHIP (although Medicaid has a 6-month renewal period);
- No face-to-face interview required to apply for, or renew, coverage;
- No asset tests for children; and
- Presumptive eligibility for pregnant women.
Building on this simplified system, in 2001, the Pennsylvania Department of Public Welfare launched COMPASS—an online program that allows families to apply for, and renew, coverage for social service programs directly from their homes or communities.
COMPASS's first offering was the state's joint application for Medicaid and CHIP, but since that time, it has expanded to enable applications and renewal for a wide range of social service programs. COMPASS links with a database of existing client information to further streamline the eligibility determination process.
Over the years, the Departments of Public Welfare and Insurance have regularly reviewed how the system is being used and made improvements as needed.
- Providing clearer instructions. In the early days of COMPASS it was discovered that thousands of users who filled out applications were failing to hit the "transmit" button—the system detected these "incomplete" applications sitting in cyberspace. In addition to person-by-person outreach to make sure those applications were submitted, the Department of Public Welfare changed the final COMPASS screen to ensure completion of the process.
- Targeting other government service users. In 2007, in an effort to reach more users of government services, "post-eligibility screening" was added to COMPASS. This means people completing applications for non-health programs get an on-screen message indicating they may, based on the information they provided, be eligible for Medicaid or CHIP. If desired, they can add health care coverage to the application prior to submitting it.
- Reducing the paperwork burden. Under a current US Department of Agriculture grant, the Department of Public Welfare is testing the ability of the Food Stamp program to scan client documents and attach them to COMPASS applications. When the pilot is completed, these scanned documents may be available to all programs using the online system to assist with verification for the non-Food Stamp programs.
- Undertaking deliberate marketing strategies. In a 2006 survey, the Insurance Department found that 70 percent of Pennsylvanians had Internet access. It was also learned that COMPASS did not have the same brand recognition as CHIP. In response, a number of steps were taken to enhance the user-friendliness of the COMPASS website, increase its prominence in advertisements and other outreach vehicles, and more explicitly link it to the CHIP program. For example, the state now does web advertising for CHIP (with a direct link to COMPASS) through search engines like Google and Yahoo.
Linking the Online Application to the Toll-Free Helpline
In 2003, to further improve the Medicaid/CHIP application process, the state, in partnership with the Pennsylvania Covering Kids & Families coalition and the state's Helpline contractor, Deloitte Consulting, decided to develop a direct link between COMPASS and the state's toll-free Healthy Kids Helpline. The proposed solution was that Helpline callers, instead of being sent a paper application in the mail, would be able, if they chose, to receive over-the-phone application assistance in the moment. Helpline staff would then submit the information through COMPASS on the caller's behalf (the paper application option remained available to callers).
Beginning in December 2003, the idea was tested and when compared to outcomes for callers who were sent an application by mail, those who had been directly linked to COMPASS had significantly higher rates of completion. Training the operators was unnecessary: they were already skilled in coaching callers on eligibility, and because the paper application had been literacy-tested, if the operator read it verbatim, it was found that the caller knew what to do. Deemed a success, in November 2004 the Helpline-COMPASS link was adopted statewide. Currently, all Helpline callers can immediately apply for, or renew, coverage for Medicaid or CHIP over the phone.
[1] EPSDT, the Early Periodic Screening, Diagnosis and Treatment program, is the child health component of Medicaid. EPSDT provides a structure for, and guidance to, states on providing health care services for children in Medicaid and requires states to cover all medically necessary services.
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- Summary
- Background/History
- Primary Support
- Program Elements
- Funding
- Results
- Lessons Learned
- Contacts
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Last Updated
February 2008
Pennsylvania:
Streamlined Enrollment & Renewal through Technology
Background/History
In the early 1990's, a lawsuit on EPSDT[1] service delivery in Pennsylvania brought advocacy groups and government staff together to develop strategies for improving access to health care. Because Medicaid and the then-state-funded Children's Health Insurance Program (CHIP) were housed in different agencies (the former in the Department of Public Welfare and the latter in the Insurance Department), the need for joint efforts and strategic alignment of policies and practices was pronounced.
Following the launch of the federal State Children's Health Insurance Program (SCHIP) in 1998, these working sessions resulted in development of a key product: a joint Medicaid and CHIP application that was literacy tested and more user friendly. Additional Medicaid and CHIP enrollment and renewal policies and practices used in Pennsylvania include:
- 12 months continuous eligibility for CHIP (although Medicaid has a 6-month renewal period);
- No face-to-face interview required to apply for, or renew, coverage;
- No asset tests for children; and
- Presumptive eligibility for pregnant women.
Building on this simplified system, in 2001, the Pennsylvania Department of Public Welfare launched COMPASS—an online program that allows families to apply for, and renew, coverage for social service programs directly from their homes or communities.
COMPASS's first offering was the state's joint application for Medicaid and CHIP, but since that time, it has expanded to enable applications and renewal for a wide range of social service programs. COMPASS links with a database of existing client information to further streamline the eligibility determination process.
Over the years, the Departments of Public Welfare and Insurance have regularly reviewed how the system is being used and made improvements as needed.
- Providing clearer instructions. In the early days of COMPASS it was discovered that thousands of users who filled out applications were failing to hit the "transmit" button—the system detected these "incomplete" applications sitting in cyberspace. In addition to person-by-person outreach to make sure those applications were submitted, the Department of Public Welfare changed the final COMPASS screen to ensure completion of the process.
- Targeting other government service users. In 2007, in an effort to reach more users of government services, "post-eligibility screening" was added to COMPASS. This means people completing applications for non-health programs get an on-screen message indicating they may, based on the information they provided, be eligible for Medicaid or CHIP. If desired, they can add health care coverage to the application prior to submitting it.
- Reducing the paperwork burden. Under a current US Department of Agriculture grant, the Department of Public Welfare is testing the ability of the Food Stamp program to scan client documents and attach them to COMPASS applications. When the pilot is completed, these scanned documents may be available to all programs using the online system to assist with verification for the non-Food Stamp programs.
- Undertaking deliberate marketing strategies. In a 2006 survey, the Insurance Department found that 70 percent of Pennsylvanians had Internet access. It was also learned that COMPASS did not have the same brand recognition as CHIP. In response, a number of steps were taken to enhance the user-friendliness of the COMPASS website, increase its prominence in advertisements and other outreach vehicles, and more explicitly link it to the CHIP program. For example, the state now does web advertising for CHIP (with a direct link to COMPASS) through search engines like Google and Yahoo.
Linking the Online Application to the Toll-Free Helpline
In 2003, to further improve the Medicaid/CHIP application process, the state, in partnership with the Pennsylvania Covering Kids & Families coalition and the state's Helpline contractor, Deloitte Consulting, decided to develop a direct link between COMPASS and the state's toll-free Healthy Kids Helpline. The proposed solution was that Helpline callers, instead of being sent a paper application in the mail, would be able, if they chose, to receive over-the-phone application assistance in the moment. Helpline staff would then submit the information through COMPASS on the caller's behalf (the paper application option remained available to callers).
Beginning in December 2003, the idea was tested and when compared to outcomes for callers who were sent an application by mail, those who had been directly linked to COMPASS had significantly higher rates of completion. Training the operators was unnecessary: they were already skilled in coaching callers on eligibility, and because the paper application had been literacy-tested, if the operator read it verbatim, it was found that the caller knew what to do. Deemed a success, in November 2004 the Helpline-COMPASS link was adopted statewide. Currently, all Helpline callers can immediately apply for, or renew, coverage for Medicaid or CHIP over the phone.
Browse
- Summary
- Background/History
- Primary Support
- Program Elements
- Funding
- Results
- Lessons Learned
- Contacts
View
Download
Last Updated
February 2008