Administrative Simplification Strategies to Increase Coverage  BadgerCare Plus

Administrative Simplification Strategies to Increase Coverage BadgerCare Plus PowerPoint PPT Presentation


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2. Topics Presented. Overview of BadgerCare PlusEnrollment ResultsAdministrative Simplification StrategiesEligibility Policy ChangesElectronic Employer Verification of Health Insurance (EVHI)On-line applications (ACCESS). 3. Overview of BadgerCare Plus. Began in February 2008Includes all child

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Administrative Simplification Strategies to Increase Coverage BadgerCare Plus

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1. 1 Administrative Simplification Strategies to Increase Coverage BadgerCare Plus

2. 2 Topics Presented Overview of BadgerCare Plus Enrollment Results Administrative Simplification Strategies Eligibility Policy Changes Electronic Employer Verification of Health Insurance (EVHI) On-line applications (ACCESS)

3. 3 Overview of BadgerCare Plus Began in February 2008 Includes all children (children above 300% FPL pay full cost) Pregnant Women up to 300% FPL Parents and caretaker relatives up to 200% FPL Certain self-employed parents & farmers with incomes up to 200% of the FPL (depending on depreciation)

4. 4 Enrollment Results Prior to BC+ August 2008 Increase Children 309,790 365,006 55,216 Parents/Caretakers 158,493 186,390 27,897 Pregnant Women 15,636 17,889 2,253 Totals 483,919 569,285 85,366 (17.6%)

5. 5 Eligibility Policy Changes Created one comprehensive program (called BadgerCare Plus) by combining SCHIP and other Medicaid programs for low-income children and families Simplified financial and non-financial eligibility policies

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8. 8 Eligibility Policy Changes Simplified gross income test Only two deductions -Earned income of minors disregarded -Court-ordered child support obligations

9. 9 Eligibility Policy Changes Spend down option for pregnant women to 300% of the FPL and children ineligible due to health insurance access/coverage to 150% FPL. Backdating (up to three calendar months) for parents and children under 150% FPL and ALL pregnant women

10. 10 Eligibility Policy Changes Alignment with Wisconsin FoodShare policies (i.e. reduced reporting policies-only report income for BadgerCare Plus if changes occur above a certain threshold such as >150% FPL or >200% FPL)

11. 11 Employer Verification of Health Insurance (EVHI) EVHI is used to determine non-financial eligibility of BadgerCare Plus applicants that are employed If employer pays at least 80% of major medical health insurance plan, individuals are not eligible to enroll in BadgerCare Plus

12. 12 Employer Verification of Health Insurance (EVHI) Pre-BadgerCare Plus employer verification process was manual and required applicant to obtain verification from his or her employer prior to eligibility confirmation This process deterred many families from applying or completing the application process.

13. 13 Employer Verification of Health Insurance (EVHI) EVHI Database implemented in May of 2008 Database includes employer health insurance information Currently updated by local agency staff and EDS State is reaching out to employers for up-to-date information about health insurance policies available to employees

14. 14 Employer Verification of Health Insurance (EVHI) Benefits of EVHI State of Wisconsin’s goal is to streamline process for determining individual’s eligibility for and enrollment in BadgerCare Plus EVHI database designed to be easily accessed by local agency staff, State staff and employers

15. 15 On-line Applications -ACCESS Total Number of Applications: 98,596 Percent of Total Applications: 29% 65,481- Requested FoodShare 72,442 -Requested Medicaid & BadgerCare Plus 21,877- Requested Family Planning Waiver Services

16. 16 Increase program participation Make it easier (and more appealing) to apply for and maintain benefits Improve customer service and satisfaction Create a 24 x 7 customer service model Provide alternatives to meeting with or calling a worker Ease workload for local agencies Reduce time spent on data entry Reduce customer calls Improve payment accuracy Make it easier for workers to track and process changes

17. 17 ACCESS Wisconsin is based on direct input from customers and other end-users 40+ focus groups and design review sessions with low-income residents, advocates, and local agencies People icons Friendly, encouraging text at a 4th grade level Personalized pages, results and next steps Quick, simple, intuitive navigation

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21. 21 Less than 5 percent of applicants indicate that they are getting help from someone else 79% female, 21% male White: 76%, African-American: 15%, Hispanic: 4%, Asian: 2%, Other: 2% Households with: At least one child under age 19: 56% Someone over age 65: 3% Someone with disabilities: 13% Earned income: 64% Unearned income only: 8% No income reported: 27%

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26. 26 ACCESS training environment http://trn.access.wisconsin.gov You can use this version of ACCESS to submit sample applications without actually applying for benefits Monthly usage report http://dhfs.wisconsin.gov/em/access/reports/data.htm ACCESS handbook for local agencies http://emhandbooks.wi.gov/ah Questions about ACCESS Wisconsin? [email protected], 608-266-0157

27. 27 For Additional Information About BadgerCare Plus Contact: Angela Dombrowicki, Director Bureau of Enrollment Management Department of Health Services 608-266-1935 [email protected]

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