What behavior change interventions have been implemented with regard to this behavior?
Administrative simplification within the Medicaid program, specifically in the enrollment process has been shown to increase Medicaid enrollment levels.
Describe the interventions
The enrollment process generally has several steps on which Medicaid programs may focus their administrative simplification efforts. These components of the enrollment process are listed below.
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1. Application forms;
2. Documentation requirements;
3. Application submission and review processes;
4. Applicant identification and assistance; and
5. Recertification procedures.
Each of these areas can be streamlined, improved, and made more accessible to enrollees through administrative simplification interventions. The ACA has mandated that each state simplify their Medicaid enrollment process.
Describe groups that have benefited from the various evidence-based intervention
Certain states have customized their enrollment processes to be “Fast Track” enrollments. These processes have had dramatic results with some states experiencing reductions in the number of uninsured by 10% after only one month of the new process being in place.
The new Fast Track enrollment consists of the following:
- Identifying potentially eligible individuals through existing data sources.
- Sending a streamlined enrollment form with simple questions, minimal information requests, and in some cases a toll-free number allowing telephonic signatures.
- Once the state received the form back, they verified non-financial eligibility. This step usually consists of verifying the potential member’s citizenship.
- They then confirm eligibility for the member and reminded them of coverage start dates.
- Finally they facilitated enrollment into a health plan (if applicable). Some states offer managed care type health plans of which the consumer must select.
RE-AIM ELEMENTS:
- R: Reach
- E: Efficacy
- A: Adoption
- M: Maintenance