Building User-Friendly Medicaid Eligibility Systems with The Work Number®

Over the past two decades, Medicaid directors have managed drastic changes either through policy
developments like the enactment of the Affordable Care Act (ACA) or crises like the COVID-19 Public Health Emergency (PHE). Often facing an overwhelming volume of benefit applications and renewal determinations, state agencies are always looking for solutions to help them address efficiency as well as the quality of service they’re able to deliver to their constituents.

As caseworkers focus on verifying the income and eligibility of beneficiaries, agency leaders are smart to continue to pursue the automation of renewals, known as “Ex parte”, to help reduce administrative burdens for state eligibility workers and enrollees. Ex parte renewals can also help address long-standing issues, such as Medicaid enrollees losing coverage at renewal solely due to accidental procedural disenrollments despite still being eligible.

A procedural disenrollment occurs when the state cannot verify an individual’s ongoing Medicaid eligibility at renewal - whether this be due to lack of data, responses, or other manual effort related delays. This lack of verification can lead to a loss of Medicaid coverage even if the individual is still eligible for the benefit. 

Leveraging The Work Number to Help Expedite Ex Parte or Automated Renewals

While caseworkers strive to enhance the eligibility determination processes and outcomes,, state Medicaid leaders should consider utilizing  third-party data sources such as The Work Number to help improve ex parte renewal processes, limit unnecessary procedural terminations, and make timely and effective eligibility determinations. 

While the public data sources caseworkers often rely on are often ‘stale’ or ‘out of date,’ The Work Number provides access to current information as it is updated each time a contributing employer or payroll provider processes payroll. This can help state Medicaid staff access current data instantaneously for their ex parte processes to help streamline and expedite Medicaid renewals.