A $100 million effort to upgrade the state’s antiquated Medicaid enrollment system is vital to Georgia’s ability to handle potentially hundreds of thousands of new enrollees when the program expands in 2014, officials say.
Replacing the outdated technology that helps caseworkers determine eligibility will also make the process speedier and easier for applicants, who will be able to apply online, said Jon Anderson, Medicaid deputy chief with the state Department of Community Health.
The goal is to eliminate any barriers and make sure people get sent to the right programs the first time around, he said.
Nationwide, the federal government is offering increased funding to states for system improvements to prepare for the Medicaid expansion under the new health care law, which is expected to increase enrollment by 15.9 million by 2019, according to the nonprofit Kaiser Family Foundation.
In Georgia, Medicaid and PeachCare for Kids provide health care coverage for roughly 1.6 million poor and uninsured individuals -- costing the state $1.7 billion annually. With the expansion, another 600,000-plus people could be added to the Medicaid rolls.
“Without these upgrades, we will collapse in a pile of paperwork,” said department spokesman Ryan Deal, adding that the aging system needs upgrading regardless of the Medicaid expansion.
Many states are facing the same problem, said Tim Sweeney, a health care analyst with the nonpartisan Georgia Budget and Policy Institute. “To call these antiquated systems is generous.”
New technology would allow Medicaid programs to easily share data, such as income and identity information, with other departments, making the eligibility process less cumbersome and labor-intensive, Sweeney said.
Georgia is pumping $10 million, part of the state's 2012 budget, into improving its more-than-decade-old system with a federal match of $90 million. Anderson said he hopes to have the new system in place by Jan. 1, 2014.
Historically, the federal government has offered a 50-50 match rate; the new 90-10 match is only available through 2015, said Jerry Dubberly, the Department of Community Health’s Medicaid division chief.
The goal is for states to streamline their systems with user-friendly, automated technology that will determine what programs people are eligible for, said Julia Paradise, associate director of the Kaiser Commission on Medicaid and the Uninsured. If someone applies for Medicaid but is eligible for a health insurance exchange, their information will be transferred without having to reapply, Paradise said.
“You want a system where there is no gap,” she said. “No matter which door you go in through, you end up in the right place.”
Right now, those multiple points of entry into the system don’t always communicate, forcing some applicants to start over, Dubberly said.
Technology upgrades will also speed up the process, reduce errors and ease workloads for caseworkers, Paradise said. In Georgia, the number of eligibility workers who serve families' needs, such as Medicaid or food stamps, has fallen to 1,913 this year, compared with nearly 2,400 in June 2009, with no plans to hire more staff, according to the Department of Human Services.
Right now, caseworkers can verify information, such as income, by pulling it from outside databases, but then they have to retype it into the eligibility system, Anderson said.
The new system will automatically pull that data and input it, and applicants will typically have to provide less physical documentation, he said. Access to more sophisticated sources of data may also help avoid Medicaid fraud because workers can more easily verify citizenship status and other key information, he said.
While the enhanced federal funding must still receive final approval, Dubberly said it’s expected to move forward and a group is already working on the project.
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