Maximizing Enrollment: Transforming State Health Coverage

Health_Family_Photo_0Maximizing Enrollment: Transforming State Health Coverage was a $15 million, five-year national initiative concluded in January 2014. The program aimed to help states transform their eligibility and enrollment systems to improve enrollment and retention of those eligible for Medicaid and the Children’s Health Insurance Program (CHIP). Initiated as Maximizing Enrollment for Kids in 2009, before enactment of CHIP reauthorization and the Affordable Care Act, the program leveraged new funding opportunities and strategies in these federal laws to advance the goal of maximizing enrollment of eligible individuals. Maximizing Enrollment aimed to improve state health coverage programs’ systems, policies and procedures and document the impact of these changes. States participating in the program worked to increase the efficiency and effectiveness of Medicaid and CHIP in enrolling and retaining eligible individuals, and the program aimed to establish and promote these best practices in all states.

In February 2009, eight states (Alabama, Illinois, Louisiana, Massachusetts, New York, Utah, Virginia, and Wisconsin) were selected through a competitive process to receive up to $1 million in grant funding along with technical assistance and peer-learning support over four years. NASHP provided technical assistance and direction as the national program office for Maximizing Enrollment. The initial phase of the program focused on an in-depth assessment of the strengths and weaknesses in the participating states’ Medicaid and CHIP enrollment and retention systems, policies and procedures. In addition to tailored technical assistance provided to grantees to develop and implement improvement plans, NASHP provided peer-to-peer learning opportunities to share information about challenges and effective strategies. Throughout the program the states received support to implement strategies focused on:

  • Simplifying processes and reducing paperwork
  • Using new technology to achieve more efficient and consumer friendly enrollment systems
  • Using data more effectively to guide and evaluate improvements
  • Changing the culture and improving coordination among agencies

Lessons learned from the program were shared nationwide over the course of the program so that other states and stakeholders could benefit from the eight states’ experiences. This webpage offers resources developed during the program, including a self-assessment toolkit with questionnaires states can use to diagnose their own enrollment strengths and weaknesses, presentations from meetings convened to discuss promising enrollment and renewal practices, and reports, webinars, and briefings detailing lessons learned from the participating states.


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