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Tuesday, August 19, 2014

Fast-Track Enrollment Could Save Your State Valuable Time, Money, and Staff Resources—All While Increasing the Number of People Who Get Health Insurance

New data from the Department of Health and Human Services (HHS) demonstrate the marked success of recent enrollment efforts: Since before the first open enrollment period to buy health insurance under the Affordable Care Act, enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) has grown by 7.2 million people.

This increase is particularly striking in states that have decided to offer Medicaid to all adults with incomes below 138 percent of the federal poverty level, which creates a seamless system of affordable health coverage for low-income people. A few states have taken an even bigger step toward expanding coverage to low-income people by adopting the “fast-track” enrollment strategy, which enrolls large numbers of eligible people quickly and has been particularly successful. 

”Fast-track” enrollment is a term for CMS-approved enrollment strategies that allow state Medicaid agencies to rapidly process applications of people who receive SNAP (formerly known as food stamps) or parents of children who are enrolled in Medicaid or CHIP who are likely eligible for Medicaid. 

From a consumer’s perspective, the process is simple: A consumer receives a letter in the mail informing him or her about Medicaid eligibility. The consumer then responds to the letter indicating whether he or she would like to enroll in Medicaid.

Fast-track enrollment could save states money and help consumers get covered quickly

The numbers speak for themselves. In the handful of states that have implemented these strategies (Arkansas, California, Illinois, Oregon, and West Virginia), more than 550,000 people have been enrolled in Medicaid. Oregon and West Virginia were able to cover more than 25 percent of their total uninsured population through fast-track enrollment alone. (One other state, New Jersey, has adopted fast-tracking but has yet to implement it.)

Despite these successes, it can be challenging to get states to adopt fast-track enrollment. As advocates and consumers look for ways to encourage their state to adopt fast-track strategies for the second open enrollment period, they may need to provide policymakers with more information than just how many people have been covered through these processes. 

Earlier this summer, we co-released a brief  with Enroll America that examined the administrative costs and savings of implementing fast-track enrollment. The results were striking. Using West Virginia as a case study, we found that the state actually saved money after implementing fast-track enrollment—to the tune of approximately $270,000, even after accounting for startup costs. And that was just the first round. Now that the startup costs have been incurred, West Virginia could do more rounds of fast-track enrollment and generate additional savings. 

Fast-track enrollment strategies significantly streamline the enrollment process for government staff. In both of the states we profiled, the average processing time for applications dropped from roughly 30 minutes to between two and three minutes. Given that these states processed tens of thousands of enrollments via fast-track strategies, the overall reduction in staff time translated to significant savings. 

States that adopt fast-tracking can maximize taxpayer dollars by running Medicaid more efficiently

Overall, these data indicate that fast-track enrollment benefits both the state and its residents. Fast-track enrollment is not just a strategy to quickly cover more individuals and families—it’s a process that promotes efficiency in how Medicaid is run. By reducing redundancies, fast-tracking maximizes how taxpayer dollars are used to benefit vulnerable residents. 

This is a political no-brainer. It’s time for states to move forward, make the smart decision, and implement fast-track Medicaid enrollment. 

Sanjay Kishore contributed to the writing of this post.