Innovations in Health Reform Update April 2013  (pdf)

When it comes to innovators in health reform, Oklahoma deserves special recognition for taking steps to put an online real-time eligibility and enrollment system into place even before the ACA passed. In 2007, Oklahoma began planning for a first-class paperless application system for its Medicaid program, SoonerCare. Since 2010, Oklahoma has had a No Wrong Door online application that provides 24-hour, 7-day a week access to online enrollment and benefits for its most vulnerable population.

In this month's interview, Nico Gomez, CEO at Oklahoma Health Care Authority, and Derek Lieser, Director of Enrollment Automation & Data Integrity, tell our readers what led Oklahoma to create a modern, streamlined system and share the lessons learned with other states. They discuss how they overcame initial operational challenges, along with the importance of their rules engine - the software system that automatically determines an applicant’s eligibility. According to an independent evaluation, the results have been remarkable.

Evaluation of Express Lane Eligibility

Mathematica's report, CHIPRA Mandated Evaluation of Express Lane Eligibility: First Year Findings, provides analysis of nine programs in eight states approved for Express Lane Eligibility (ELE) as of April 2012. Key findings from ELE-early adopters highlighted in this report will provide lessons for other states looking to automate their eligibility processes and build in greater efficiency. This evaluation provides descriptive analysis of the costs associated with ELE implementation in six states (AL, IA, LA, MD, NJ, and OR) and of the enrollment trends in four states (AL, IA, LA, and NJ). It estimates the impact of ELE adoption on total enrollment in eight ELE states (AL, GA, IA, LA, MD, NJ, OR, and SC) and previews issues that will be examined and presented in the final Report to Congress to be submitted in September 2013.