1. Fixing the Leaky Sieve: Federal and Plan Solutions to Churning ACAP CEO Summit, July 15, 2009 Georganne Chapin, President & CEO Hudson Health Plan Hudson Center for Health Equity & Quality Tarrytown, NY gchapin@hudsonhealthplan.org

3. Hudson Health Plan Founded in 1985 by four Community Health Centers 85,000 members in New York’s lower Hudson Valley (North & West of NYC) Mixed urban, suburban and rural in character

4. Hudson Center for Health Equity & Quality Founded in 2005 Focus on policy and technology “Promoting a humane, cost-effective, high quality health care system”

6. New York’s Public Insurance Programs Medicaid Managed Care Child Health Plus Family Health Plus

7. “Facilitated Enrollment” Community-based Health Plan-based Decentralized (55 counties + NYC) Largely manual/paper-based

8. Health Plans as Enrollers Field-based “On the street” “Community outreach vehicles” Satellite offices Events Extended hours

9. Enrollment Challenges Current paper-based environment: –Error-prone, manual application process –Inefficient administrative systems –Excessive churning (disenrollment and re- enrollment of eligible people) –High cost to manage process

10. Typical Enrollment & Eligibility Cycle FE fills out 8-page form with applicant FE collects identification, proof of income, and other verifying documents Paper application audited by health plan/FE and returned to FE/marketer to correct/complete Applicant re-contacted for additional/correct info Application re-submitted for audit Application batched and shipped to local district by messenger Application reviewed and audited by local district Application returned to health plan/FE for corrections/completion Etc….

11. OUR GOAL: SIMPLIFY Speed up time between sign-up & effective enrollment Reduce errors Reduce paper (processing and storage) Reduce costs across the system Increase enrollment and retention

12. Facilitated Enrollment Electronic Application – The FEEA Solution Developed by Hudson Health Plan Software license transferred to Hudson Hcheq Now live in 13 counties + New York City

13. FEEA at the Health Plan Laptop and/or network installation Connected and/or wireless Password protected with role based security Data transmission via secure VPN Full printing and scanning capability

14. Easy to Use Windows © -based user interface Logical data entry screens Rule-driven data integrity Automatic calculations State/federal rules always on screen Documentation check-list

15. Improved Quality Zero legibility issues No calculation errors Facilitates enroller/auditor communication Provides reports and management tools Automates NYS fraud and abuse requirements.

17. The Future of Public Program Enrollment in New York State

18. The Future Customer Self Service: www.EnrollNY.org –Sends qualified leads to participating FE’s –Provides on-line access to leads –Lowers cost of enrollment

19. www.EnrollNY.org

20. Quick and easy eligibility calculator

21. www.EnrollNY.org Eligibility calculator Identifies programs for which users may qualify Easily start the online application Eligibility calculator Identifies programs for which users may qualify Easily start the online application

22. www.EnrollNY.org Basic lead information is captured including contact information

23. www.EnrollNY.org User selects Facilitated Enroller in their county Privacy policy obtains permission to send the information to the Facilitated Enroller

24. www.EnrollNY.org User can stop at this point An option to FastTrack their application captures most other Access NY application information

25. www.EnrollNY.org FastTrack allows entry of additional information for each household member

26. www.EnrollNY.org Users start applications online They get connected with a facilitated enroller The FE can retrieve qualified leads via their online inbox Leads can be uploaded to FEEA

27. Future Vision for Enrollment Electronic application replaces paper Self-service replaces reliance on government and health plan staff Statewide solution replaces local district variation Electronic transmission and storage replaces trucks and file cabinets People get and keep coverage

28. And someday, everybody will have health care.

29. Fixing the Leaky Sieve: Federal and Plan Solutions to Churning ACAP CEO Summit, July 15, 2009 Georganne Chapin, President & CEO Hudson Health Plan Hudson Center for Health Equity & Quality Tarrytown, NY gchapin@hudsonhealthplan.org