States Using IT To Streamline Procedures for Medicaid, CHIP


In 2011, many U.S. states used IT systems to expand and simplify their eligibility, enrollment and renewal procedures for Medicaid and the Children's Health Insurance Program, according to a report released Wednesday by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, Government Health IT reports (Mosquera, Government Health IT, 1/18).

Medicaid, CHIP Coverage Remains Stable in 2011

The annual 50-state report found that the number of U.S. residents who had health insurance through Medicaid or CHIP remained stable in 2011, despite a struggling economy.

Overall, 11 states took steps to expand coverage, and eight of those states focused on expanding coverage for low-income, uninsured children (Quinton, National Journal, 1/18). Meanwhile, just two states reduced Medicaid enrollment last year, according to the report (Daly, Modern Healthcare, 1/18).

Leveraging IT Systems

According to the report, many states are using IT systems to improve the efficiency of their Medicaid and CHIP programs. For example, some states have used technology to:

  • Accelerate eligibility determination through coordination with other health programs;
  • Create easier renewal options;
  • Improve online application processes; and
  • Verify citizenship status with the Social Security Administration.

The report noted that Oklahoma is the only state to use a fully automated, online system to determine residents' eligibility for Medicaid and CHIP. The system processes more than 1,000 online applications per day, and 90% of users receive immediate decisions on their eligibility status after the system checks various electronic data sources.

Using IT To Prepare for Medicaid Expansion

The report also found that many states are using CMS funding to enhance their IT systems in preparation for the 2014 Medicaid expansion mandated by the federal health reform law.

CMS is providing 90% in federal matching funds through 2015 to help states cover the costs of designing and upgrading their Medicaid eligibility and enrollment systems. As of Jan. 1, CMS had approved system upgrades for 18 states, and an additional 11 states had submitted plans (Government Health IT, 1/18).

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