In 2010, the Massachusetts Medicaid Policy Institute (MMPI) released an illuminating, wide-reaching report: “Enrollment and Disenrollment in MassHealth and Commonwealth Care” (HCFA coverage). The report detailed the scope of “churn” in public coverage in Massachusetts.
Three years later, the Institute has just released an optimistic update to its original report. “Enrollment Volatility in MassHealth: A Progress Report,” written by Robert Seifert and Amanda Littell-Clark of the University of Massachusetts Medical School’s Center for Health Law and Economics, details some of the recent steps taken by MassHealth to reduce gaps in coverage and offers recommendations for improvements that still need to be made in order to ensure continuous enrollment in health insurance coverage .
Here are some highlighted improvements:
- Automatic annual renewal program for MassHealth members in certain subgroups determined to have stable circumstances, like seniors in elder care facilities, adults with disabilities, and elders living in the community.
- Express Lane Renewal for Children, parents, and their caregivers enrolled in both MassHealth and SNAP, which automates the renewal process of MassHealth by using data from SNAP.
- MassHealth has leveraged data from the Social Security Administration so that paper verification of citizenship and identity is no longer necessary.
- Electronic Document Management organizes all paperwork mailed or faxed to MassHealth into a centralized system which can be accessed by all eligibility workers in the program.
- Phone routing system that ensures that callers reach the first available eligibility worker at any MassHealth enrollment center.
The report also points to areas that continue to need improvement. While call wait times have reduced, many surveyed still believe they are unacceptably long. Paperwork processing delays remain a problem for some as well. Respondents also cite the language used in MassHealth notices as too complex, at too high a reading level, and packed with confusing jargon, while enrollees who cannot read English or Spanish run up against language barriers.
ACA implementation poses new challenges, as well as opportunities, for MassHealth. As the ACA requires several adjustments to the MassHealth renewal process, staff in the program will need to quickly modify existing procedures before the new regulations go into effect. Report interviewees indicated that these challenges will require additional staff, especially in the areas of outreach and enrollment. The report recommends additional funding for MassHealth administration, which could help fund these additional positions as well as trainings for the existing staff.
We applaud the progress MassHealth has made in just three years. The improvements demonstrate an organizational commitment to addressing the concerns of its members and other stakeholders. It is critical that these efforts continue as the state moves to implement the Affordable Care Act and guarantee care to even more citizens of the Commonwealth.