New OrleansNovember 13-15, 2002

Supporting Families: Improving Health Care Eligibility Processes

Minnesota Department of Human Services

11/5/02 2

Collaborative Work Groups

• Coordination of Medicaid and MinnesotaCare

• Alternative applications

• Notices and forms

• Simplifying requirements

• Passive review

• Focus groups

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Cycles tested: #1

Aim: Identify needed improvements in Medicaid closure notice

Action: Surveyed workers at two counties

Interviewed clients at same two county locations

Results: General observations that notice is confusing, contains too much information, is badly

laid out.

Specific suggestions for improvement.

Next Step: Complete development of reworked form and test at two locations.

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Cycles tested: #2

Aim: Increase the number of MinnesotaCare applications while decrease the processing time

Action: Piloted phone-in applications

Results: 16 of 36 callers completed app over the phone

6 of the 16 apps that were mailed out came back

4 of the 6 were denied, 2 were approved

Next Step: Tweak the process to increase the percentage of approved applications by doing more

screening while completing the application. Pilot changes.

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Cycles tested: #3

Aim: Further define enrollment barriers.

Action: Survey of outreach workers.

Results: Top five answers are:

- Culture and language issues

- Problems with worker

- Difficulty providing verifications

- Embarrassment

- Trouble with forms

Next Step: Continue to get information from identified focus groups

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Cycles tested: #4 - In progress

Aim: To improve coordination between programs.

Action: New Procedures for transferring applications back and forth between MinnesotaCare

and Ramsey County

Expected

Results: Fewer lost applications, shorter processing time, better communication between workers

Next Step: To be determined

11/5/02 7

Continuing DHS pilot - Credit card payments

Aim: To decrease the number of MinnesotaCare enrollees closed for non-payment of

premium

Action: Begin accepting credit card payments, concentrating on households in danger of being

closed.

Results: Mixed. Lots of enrollees are using this option, but numbers of closures are going up.

Next Step: Analysis of what other things are affecting this number. (Continued on next slide)

11/5/02 8

Credit card payments - continued

Hypotheses:

• Enrollees who know that they are over the limit for the asset test implemented 7/1/02 may be disenrolling by not paying the premium

• Children formerly enrolled in MinnesotaCare may have moved to Medical Assistance because they meet the new income limit of 170% FPG which went into effect 7/1/02

• Elimination of grace month in July may still be affecting some households

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MinnesotaCare Closures by Reason Code

Total # Case Closures

Other Coverage % Nonpayment %

Failure to comply with procedures % Requested %

Other Categorical Reasons %

Apr-98 3,169 1087 34% 917 29% 642 20% 154 5% 369 12%Apr-98 3,131 989 32% 970 31% 612 20% 173 6% 387 12%May-98 3,716 972 26% 1,172 32% 928 25% 284 8% 360 10%

**See NotesJ un-98 4,902 975 20% 2,863 58% 343 7% 249 5% 472 10%J ul-98 4,100 861 21% 2,235 55% 334 8% 206 5% 464 11%

Aug-98 5,974 770 13% 4,041 68% 423 7% 237 4% 503 8%

# Case Closures by Reason