EOHHS Virtual Gateway: Health Insurance and Health Assistance Programs
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1 : Health Insurance and Health Assistance Programs Maximizing Enrollment Massachusetts State-to-State Exchange National Academy of State Health Programs Commonwealth of Massachusetts March 2011
2 What is the Virtual Gateway? Public Agency Worker Service Providers Centralized Portal for Health and Human Services at Mass.gov/vg Health and Human Services
3 The Programs Programs that can be applied for online: Health Insurance and Health Assistance Programs: MassHealth, Commonwealth Care, Health Safety Net Healthy Start, Children's Medical Security Plan (CMSP) MassHealth for Seniors / Long-Term-Care Services at home Child Care Supplemental Nutrition Assistance Program/SNAP (formerly Food Stamps) Women, Infant, and Children (WIC) Services Community Services and Long-term Support: Elder home care Vocational rehabilitation Individuals who are legally blind Children with developmental disabilities Adults with intellectual disabilities (including mental retardation) Assistive Technology Fund for the Deaf and Hard of Hearing Case Management / Social Services for Deaf, Hard of Hearing Adults and children with a mental health condition Veterans seeking inpatient, outpatient, or domiciliary care (Soldiers' Homes)
4 Beginnings Beginnings: Why Mass. created the Gateway ü Key factors / Underlying Context: ü VG offered the many EOHHS agencies an electronic front door a way to electronically facilitate their interaction and organize their services ü Medicaid had greatest number of clients of EOHHS programs made sense to center VG around it ü State tax shortfalls in 2002/2003 Needed to find budgeting efficiencies among agencies ü Hospital uncompensated care program reimbursements unsustainable ü Applying for Medicaid at point of admittance would increase number of eligible individuals receiving it, reducing free care draws
5 Beginnings Beginnings: Why Mass. created the Gateway ü Players in early development and ongoing maintenance: ü Initial programs / agencies: ü SNAP (formerly Food Stamps) ü Child Care ü Women s Health Network ü Substance Abuse (screening only) ü WIC ü Region I CMS very supportive, particularly on FFP issues ü Secretary of Mass. EOHHS - background ü The Governor s Office ü Strong core team from operations and secretariat levels ü Agency staff were recruited in short period of time
6 Beginnings Beginnings: Why Mass. created the Gateway ü Early and ongoing challenges: ü Reorganizing agencies / programs to focus on ongoing VG maintenance and operations ü Turf / Silo issues among agencies ü Inter-program legal framework took time to sort out ü Costs ü Concept to release only 18 months ü Early build costs well under $7M ü However, ongoing operational and incremental enhancement costs needed to be budgeted
7 Access Methods Behind the Scenes EOHHS Client Services Eligibility Screening Catalog of Services Basic Needs Cash Assistance Food Medical? Public Catalog of Services Basic Needs Cash Eligibility Assistance Screening Food Medical? Common Application MAP / Change Form / SLR MAP / Change Form / SLR Intake Worker Catalog Screening MAP / Change Form / SLR Catalog Screening Application Intake Enrollment Status MAP / Change Form / SLR XML MassHealth, etc.: MA21 SNAP, etc.: Beacon Child Care: eccims Virtual Gateway
8 The Benefits Streamlined Common Application Intake Improve Access Migrate from Paper to Electronic Decrease Inaccuracies In Determination Improve Back Office Processes Decrease Cycle Time In Determination Right Services Right Financials Minimize Administrative Impact of Health Safety Net and Commonwealth Care / Health Care Reform Process Migration to MassHealth
9 Virtual Gateway Home Page Virtual Gateway Home Page: mass.gov/vg Public Intake Worker
10 Determining if Virtual Gateway Appropriate First, check My Account Page for any Family Group member already known to MassHealth If any FG member is found on MAP: ü Review MAP information with client ü Call local MassHealth Enrollment Center (MEC) if questions
11 Determining if Virtual Gateway Appropriate My Account Page Overview Member Information Household Information 1 2 Benefit Information Next Steps Eligibility Notices 3 4 5
12 Pre-Screening Tool Preliminary Screening Tool allows public to answer certain questions and view what they may be eligible for before they visit a facility
13 One-Stop Shopping Efficient One stop shopping : Individuals can apply for up to 13 services at the same time, with the help of providers
14 Completing the Online Application Enter Head of Household (HOH) information 14
15 Completing the Online Application Start building Family Group member by member Select all programs that they are applying for by checking the check-boxes Use Save and Add Another to add household member
16 Completing the Online Application Registered providers continue completing online application with their clients
17 Completing the Online Application Application Confirmation page Click Save and Continue to proceed
18 Completing the Online Application Electronic Application Summary lists all information entered Application Number Click Save and Continue to proceed
19 Completing the Online Application Electronic Application Signature Page is printed, signed and mailed to MassHealth Application Number FIRST, click Print to print the 2-page Signature Page Click Save and Continue to proceed
20 Completing the Online Application Permission to Share Information (PSI) form needs to be printed, signed, and mailed to MassHealth FIRST, click Print to print the PSI
21 Completing the Online Application On the Submit Application page, indicate that signed application was received and materials will be sent to MassHealth Click signed application checkbox Click to submit applications to programs
22 Completing the Online Application Confirmation of Submittal and Next Steps page indicates submission date, head of household, application number and programs applied for
23 Completing the Online Application Confirmation of Submittal and Next Steps page also indicates next steps and required verifications
24 Completing the Online Application Confirmation of Submittal and Next Steps page also indicates verification document options Note: You can print the Confirmation of Submittal and Next Steps page to provide to the applicant for follow up.
25 Post-Submission Process Virtual Gateway Middleware Eligibility determination results Two-way messaging MA21
26 Post-Submission Process Items to be mailed to MassHealth: Completed Virtual Gateway Cover Page Electronic Application Signature Page (2 pages) Permission to Share Information (PSI) form Absent Parent Questions and Assignment of Rights (if applicable) Eligibility Representative Designation Form (if applicable) DES Supplement (if applicable) Items to be faxed to MassHealth: Completed VG Cover Page Earned Income verifications, if applicable Immigration verifications, if applicable (Green card, etc.) Health Insurance Cards, if applicable Certain non-working income verifications such as alimony, dividends, interest, rental income, etc., if applicable Assets (ONLY required for Traditional applications) 26
27 Application Tracking and Reports Application tracking functions help manage application creation and status Find an application Return to unfinished applications Generate a report
28 Change Form Change Form - Allows registered providers, assuming proper security permissions, and heads of households to update, edit, or delete certain demographic information on file with MassHealth. Minimizes client having to call or visit a MassHealth office. Less likely benefits will terminate due to incorrect address on file. 25,499 total submitted changes since December, 2008
29 EOHHS Virtual Gateway New Consumer home page reachable from mass.gov, SNAP benefits page, and the MassHealth website. Consumers can screen for potential program eligibility, apply for SNAP, or register/ log into new public facing MAP.
30 Lessons Learned Lessons Learned - General: ü Follow incremental approach: Start with the basics and grow over time. Allows users to adapt to the change and agencies to adjust to new business processes gradually. ü Build it and they might not come. Engage end users early and often: ü These tools are generally optional for users - alternatives like paper exist. Design with usability and efficiency as a top priority. ü Getting full utilization of these tools often requires a coordinated communications plan. ü Leave time for legal and policy reviews ü Production support key to keep tools up and running
31 Lessons Learned Lessons Learned, Specifics: ü Who will have access to which functions: Registered organizations, consumers or both? ü How much do you want members to see of other household members information? ü Align multiple programs and services to "fit" under one common application: ü Need "buy-in" from leaders of participating programs ü Understand / document each program s back end processes ü Understand how electronic application will communicate with each program s legacy eligibility system ü Incorporate back-end processes as seamlessly as possible: ü Where do applicants send documents post-application? ü Utilize what s been done in other states where possible
32 Lessons Learned ü Pilot, pilot, pilot Lessons Learned, Specifics, Cont d: ü Rollout gradually to limited number of users per month, week, etc ü Not just new process - new way of thinking : ü Help organizational users to think electronic rather than handing paper to patients / clients ü Utilize electronic signatures where possible minimizes paper, confusion ü Let users be your guide maintain robust dialogue with them: ü MAP, MAP fields, Paperless Notices and other enhancements were user ideas ü For Consumers make user friendly, understandable: ü Appropriate reading level ü Leverage your existing providers to help spread word to consumers
33 Questions? 33
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