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Reach Out And Keep Someone
 

Reach Out And Keep Someone

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Janette Lopez

Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Janette Lopez

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    Reach Out And Keep Someone Reach Out And Keep Someone Presentation Transcript

    • Reach Out And Keep Someone The California Experience
    • Reach Out And Keep Someone The California Experience
      • Janette Lopez
      • Deputy Director
      • Eligibility, Enrollment & Marketing
      • CA Managed Risk Medical Insurance Board
      • Removing Barriers
      • Simplify the application
      • Apply via phone
      • Apply via internet application
      • Minimize documentation requirements
      • Allow documentation to be submitted post enrollment
      Reach Out And Keep Someone The California Experience
      • Removing Barriers (cont’d)
      • Grant presumptive eligibility at various entities
      • Create enrollment gateways such as Child Health & Disability Prevention (CHDP) Program & Women Infants & Children (WIC)
      • If SCHIP program has premium requirement, bill family after enrollment v. require premium with application
      • Auto assign to a plan if family omitted selection
      Reach Out And Keep Someone The California Experience
      • Use Media for Program Recognition
        • New program – public exposure
        • Renaming the program to emphasize coverage expansion, i.e. Insure All Kids
        • Develop and promote “One Door” enrollment concept
      Reach Out And Keep Someone The California Experience
      • OUTREACH, ENROLLMENT, RETENTION & UTILIZATION (OERU) STRATEGIES
      • Need varied and multiple strategies
      • Train and reimburse application assistants
      • Outreach grants to provide cultural and linguistic appropriate outreach at the local level
      Reach Out And Keep Someone The California Experience
      • OERU (cont’d)
      • “ One Door” approach – ability to offer coverage to all children in a household regardless of immigration status
      • Local efforts also include various levels of case management to assure enrollment, member education regarding the annual review process and utilizing services
      Reach Out And Keep Someone The California Experience
      • Express Lane Eligibility (ELE)
      • Good concept – grant presumptive eligibility until a final Medicaid eligibility determination is made
      • Requires ability to interface between ELE site and the Medicaid enrollment system
      • May require funding for schools if the Free Lunch Program is included
      • May need to address differences in eligibility rules, i.e. how family size or income is determined
      Reach Out And Keep Someone The California Experience
      • ANNUAL ELIGIBILITY REVIEW PROCESS (AER)
      • Keep it simple
      • Preprint Annual Review Form
      • Develop internet based system for annual renewal
      • Minimize documentation requirements
      • Allow re-determinations by phone
      Reach Out And Keep Someone The California Experience
      • AER (cont’d)
      • Allow application assistants to assist families and provide incentives $$
      • Improve coordination with Medicaid
      • Establish presumptive eligibility (until a final eligibility determination) for children moving between SCHIP and Medicaid
      • Develop a simple process for families in SCHIP to be evaluated for Medicaid prior to their AER
      Reach Out And Keep Someone The California Experience
    • Reach Out And Keep Someone The California Experience Questions? CA Managed Risk Medical Insurance Board Janette Lopez (916) 324-4695 [email_address]