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Government agencies are facing increasing pressure to deliver services promptly and in a cost-effective manner, so that they can maximize resources while delivering appropriate payments based on an individual's eligibility. A key area demanding attention is improving the delivery of those appropriate payments to qualified applicants during eligibility determination, a process often plagued by inefficiencies.
The scope of inefficiency in the benefits payment process is substantial. Payment discrepancies have risen dramatically, from approximately $35 billion in 2003 to more than $235 billion in 2023. Federal executive agencies have reported cumulative overpayment estimates reaching about $2.7 trillion since 2003. These inefficiencies represent a significant challenege in the distribution of public funds and can undermine the effectiveness of vital programs intended to support those in need.
While reducing unnecessary spending is paramount to the current administration, agencies must also prioritize the efficient and effective delivery of benefits to eligible individuals. To achieve this balance, automated data solutions offer a crucial pathway to streamline eligibility determinations and payment processes.
Several interconnected factors contribute to inefficiencies in eligibility determinations across various programs.
These include the inherent complexity of eligibility requirements, which can be difficult for both applicants and caseworkers to navigate. This problem is often compounded by poor access to supporting data which hinders accurate and timely assessments.
Depending on the state, different agencies may have separate application processes, requiring applicants to complete multiple forms to receive their relevant benefits. When confirming the applicant’s eligibility, caseworkers often rely on manual processes, which can be more prone to potential human error and delays, introducing another layer of inefficiency. Some agencies may rely on outdated income or employment data, which can lead to inappropriate eligibilitydeterminations. The emergence of the gig economy has also further complicated caseworkers’ jobs with more applicants receiving income from multiple sources or as an independent contractor.
Integrating electronic, automated data solutions into eligibility systems provides several key advantages, including:
Access to more information enables more informed applicant profiles.
Streamlined processing eases administrative or manual burdens for caseworkers and applicants.
Expanding data sets (e.g., incarceration, household composition, financial assets) offers enhanced insights as needed.
Informed decision-making leads to more appropriate benefit eligibility determinations and payments.
Increased caseworker productivity and application throughput accelerates processing.
Forward-thinking agencies can also explore leveraging AI and machine learning to optimize application processes, such as scoring application complexity or deploying AI chatbots to guide caseworkers or applicants.
With an estimated 30 percent of the U.S. population relying on the social safety net, efficient and effective government assistance ecosystems are essential. Streamlined processes benefit both applicants and caseworkers, while also addressing administration concerns about responsible government spending.
We understand the pressures faced by social service program leaders, including shifting priorities, potential budget impacts, caseworker retention challenges, and the need to enhance program integrity. Our solutions are designed to support efficient and effective eligibility determinations, which can indirectly contribute to improved caseworker morale and optimized operations.
Connect with our government team to discover how data automation can streamline eligibility verifications and potentially generate significant savings for your agency. Our solutions can potentially help you manage:
Cost Savings: Decrease your manual verification expenses.
Caseworker Efficiency: Reduce manual processes, allowing caseworkers to manage more cases effectively and focus on complex situations.
Appropriate Payments: Determine an individual's eligibility for benefits and deliver appropriate payments in a timely manner and maximize the reach of limited resources.
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