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Eligibility & Enrollment Systems: An Advocate’s IT Toolkit

Efforts to improve public coverage programs have long been stymied by the prevalence of outdated IT systems that are the source of numerous consumer issues from confusing and conflicting notices to lost eligibility records to inadequate data to measure program performance. Meanwhile the state of technology and web-based services has advanced significantly, leaving many Medicaid systems in the dark ages. New technology is needed to not only support consumer self-service and program evaluation but also to make government work better – more efficiently and cost-effectively. Spurred by the need to implement new Medicaid rules and procedures and motivated by significant federal funding, states are moving forward in developing or adopting state-of-the-art technology, at least for their Medicaid programs. Now is an opportune time for states and a critical juncture for consumer advocates to engage to ensure that the systems being developed today not only resolve the problems we have worked long and hard to remedy but also make it easy for consumers to connect to coverage. This toolkit provides background information, questions to ask about key IT system functions and features, and strategies that advocates can use to ensure that these new eligibility and enrollment systems work well for consumers.

Download and listen to the webcast here.