1 healthy maryland! september 2010. the challenge…

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Healthy Maryland!

September 2010

The Challenge…

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Clinics

Health Plans

HospitalsER & Outpatient

Schools

Social Services

Access

Food Bank

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Clinics

Health Plans

HospitalsER & Outpatient

Schools

Social Services

Maze of Referrals

Food Bank

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Clinics

Health Plans

HospitalsER & Outpatient

SchoolsPaper Forms

Social Services

Food Bank

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Clinics

Health Plans

HospitalsER & Outpatient

SchoolsManual Data Entry

Social Services

Food Bank

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Delayed and missed support for families

Lost revenue for providers and local economy

More paper and manual data entry

Impact

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Social Interest Solutions

Independent, mission-driven non-profit organization

Software development, implementation, maintenance and enhancement

Policy analysis and advocacy

Leadership and staff with long history and experience in automation and systems reform

~ 60 staff maintaining systems for AZ, CA, IN, MD

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One-e-App Technology

Web-based system accessible from many locations

Assisted and unassisted (public access) pathways

Offers a secure single point of entry

Provides simultaneous preliminary and/or final eligibility determination across multiple programs

Submits applications, signatures and documentation electronically via Internet

Application and case management tools for all users (assisted and unassisted applications)

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Implementations

Arizona: Health-e-Arizona (assisted and unassisted)

Indiana: Ind-e-App

Maryland: Health-e-Link

California: (assisted and unassisted)

– One-e-App - 15 California counties

– Statewide Kaiser Permanente Child Health Plan and CalKIDS in California

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Who Uses

Community-based organizations

Hospitals and Clinics

Call Centers

County Agencies (Social Services, Health Services, Public Health)

Schools

Health Plans

Food Banks

Public Consumers

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One-e-App Stats

Screened over 3.5 million people for potential eligibility across 4 states

Roughly 6 million applications to programs

Speeds determination – in some cases by 50% or more

Reduces need for follow-up with applicants ~78% as compared with paper

90% of public user survey respondents in AZ found the application “easy to use.”

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Examples of Features

Interview style data collection

Error checking and validations

Storage of documents and signatures

Application tracking tools

Management report generation

English / Spanish real time toggle

Notification and client communication tools (e.g. text messaging)

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Health Programs

Medicaid

SCHIP

EPSDT

County Indigent Care Programs

County Sliding Fee Programs

Adult and Child County Expansion Programs

Kaiser Permanente Child Health Plan and Kaiser Bridge

Express Lane Eligibility (school lunch / MC linkage)

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Social Services and Support Programs

Food Stamps (SNAP)

Earned Income Tax Credit (EITC)

Child Tax Credit

Supplemental Nutrition for Women, Infants and Children (WIC)

TANF (Temporary Aid to Needy Families)

Voter Registration

Low Income Energy Subsidies

Low Income Auto Insurance

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Referrals to Other Programs  

Family Planning

Cancer Detection and Treatment Programs

General Assistance

Medicare Cost Sharing

Drug and Alcohol Rehab Program

Homeless Assistance

Others

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Electronic “Interfaces” State eligibility systems in Arizona: Department of Economic Security

(DES) and Arizona Health Care Cost Containment System (AHCCCS)

State of CA for Children’s Medicaid, S-CHIP, EPSDT

State of Maryland (Spring 2010)

County Automated Welfare Systems

Health plans

Patient Management Systems and Electronic Health Records

Pacific Gas and Electric (PG&E)

US Postal Service for address verification

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Data & DocumentStorage

Case ManagementTools

HealthPlans

CountySystems

Process and Data Flow

Rules Engine Universal Interface DeterminePreliminaryEligibility

SubmitApplication

Home

CommunityBased Organization

StateSystems

- USPS- PMS- EHR- Others

applicant consent

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Snap Shot – San Francisco

Fully integrated with county and state systems

Developed and running 16 weeks

Persons Screened: 112,772 (since 9/2007)

Persons Currently Enrolled in Healthy San Francisco: over 50,000

User satisfaction with enrollment process: 86% found the process “easy” or “very easy”

Reduced Emergency Room use through enforcing use Medical Home (managed via One-e-App)

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Snap Shot - Arizona

Fully integrated with state systems

190,000 Public Applications Submitted in year one (12/28/09 – 12/31/10)

54,000 Assisted Applications Submitted

230,000 households applied for Food Stamps

95% of the FS households had a least one person eligibile for Medicaid

90% of survey respondents in Arizona found the public application “easy to use” and would use it for renewals

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One-e-App in Maryland

Launched October 1, 2008 in Howard County

Programs:

– MCHP

– MA for Families

– Healthy Howard

– PAC

– Kaiser Bridge

Interface in process with CARES to support MCHIP and MA for Families

Plan to begin UAT in November and hope to be live and in pilot in December.

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The Center and One-e-App: Unique  

Unprecedented data integration (only non-state or county system to interface with state and county systems)

More than an electronic application

Verification document storage and management

Robust communication capabilities with notices, email, text messaging

Self-service and supported assistance

Reporting (data mart support for ad hoc reports)

Case and outreach management

Demo