|
|
 |
|
Statewide Projects
Three major initiatives are planned for statewide implementation of New Hampshire’s
Covering Kids & Families grant. First, we will centralize the processing of presumptive eligibility (PE) and
community-facilitated applications. Second, we will identify and address barriers to retention. Third, we will
implement a telecounseling initiative to gather data and assist families at risk for slipping through the cracks
at various stages of the application, enrollment and renewal processes.
|
|
|
Outreach through Community Partners:
To strengthen our community partnerships we have restructured the way New Hampshire processes presumptive
eligibility and community-facilitated applications and expanded field technical support. The plan to
overhaul presumptive eligibility shifts responsibility for processing community applications to the mail-in
eligibility unit at NH Healthy Kids Corp. This plan was developed to respond to feedback from community
partners regarding barriers to effectiveness in identifying and enrolling eligible children. The following
interventions were put in place to improve the presumptive eligibility process:
- Introduced training improvements to ensure that community partners have appropriate levels of
program knowledge
- Provided customer service to community agencies submitting applications on behalf of families
- Implemented a quality assurance program to track community applications and provide
feedback to submitting agencies as a way to improve the application accuracy and completeness
- Increased technical support staff to enable greater levels of outreach support, one-on-one
training and technical assistance
- Facilitated community relationships with District Offices of Health & Human Services that remain
responsible for case management and renewals.
Through this effort, we expect community partners to be more comfortable with and more
committed to identifying eligible children and facilitating the application process.
To evaluate the effectiveness of the presumptive eligibility plan, we will track and report application
completeness, missing documents, application disposition and turnaround time by community agency for
comparison to direct mail-in applications and other agencies. These measures will be used for feedback to
community partners and to identify training issues and quality improvement opportunities.
Simplify enrollment and renewal processes:
Program evaluation indicates that New Hampshire fares relatively well in regard to retention. Nonetheless,
some families report that it is hard to stay enrolled in the program. Additionally, about one-third of
Healthy Kids Gold (Medicaid) disenrollees indicate they are no longer enrolled because their income is too
high, even though most would qualify for low-cost coverage under Healthy Kids Silver (Title XXI).
Understanding the extent and nature of retention issues is essential to removing barriers. The first year
of this grant will be dedicated to data collection and understanding the problem. This
information will be used to develop a plan to improve retention and minimize program churn. Potential steps
to improve retention could include additional follow-up with families at renewal time, encouragement of
reminder systems at community agencies to support re-enrollment, pre-printed renewal applications, passive
renewal processes and better coordination with other benefit programs.
A variety of qualitative and quantitative data sources will be examined in this process. As part of
its commitment to the CKF initiative, the Department of Health & Human Services (DHHS) will evaluate the
ability of its data warehouse and the recently implemented Medicaid Decision Support System to produce
reporting that is needed to identify and prioritize retention issues.
The Quality in the Children's Health Insurance Program (QCHIP) workgroup will be working to gather more
data from new surveys going to groups of people at various stages in the insurance process. This will
also be a part of the first year data collection. The Statewide Coalition will examine this data to
determine additional opportunities to improve retention.
Outreach, Retention and Coordination through Telecounseling:
With a joint application and eligibility determination for both programs contained within a single system,
New Hampshire has already made strides to reduce the potential for families slipping through the cracks as
eligibility shifts between Medicaid and Title XXI. Recently, the New Heights eligibility system was enhanced
to provide electronic referrals for families ineligible for State-supported programs but who may qualify
for the Healthy Kids Buy-In Program. Also, families who indicate they have a child with special healthcare
needs are referred to New Hampshire Family Voices which provides information about additional health care
support services.
Despite these efforts, not every family transitions between programs when their child’s eligibility
changes. Some 20% of families whose eligibility was determined through a local District Office do not
enroll their children in the premium-based Title XXI program. As a result, we are proposing a multi-faceted
telecounseling project to intervene via telephone with families who are in danger of slipping through the
cracks at various stages of the application, enrollment and renewal processes. Some families may respond
to friendly customer-focused representatives who can remove barriers to completing the application. For
families new to the system and for families transitioning from free to low cost insurance, a more concerted
effort may be needed to educate them about the importance of preventive and primary care and the value of
insurance. For others, eligibility problem solving may be the answer.
|
|
|
|
