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Enhancing Health Coverage for Kids and Families: Addressing Outreach and Determination Barriers

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In June 2009, the Modernization Forum highlighted critical barriers to health coverage for children and families. Many families face challenges with outdated outreach methods, confusing application processes, and inconsistent assistance. Eligibility determination often suffers from data entry errors and processing delays, leading to thousands of eligible kids remaining uninsured in Colorado. This report outlines actionable strategies to overcome these barriers, including community partnerships, simplifying income rules, improving technological systems, and ensuring eligible children maintain continuous coverage.

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Enhancing Health Coverage for Kids and Families: Addressing Outreach and Determination Barriers

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Presentation Transcript

  1. Cutting Through the Maze Stacey Moody Eligibility Modernization Forum June 2009

  2. Health Coverage for Kids and Families

  3. Welcome to the Maze

  4. Outreach Barriers Outreach hasn’t reached some families Outreach Printed form outdated Doesn’t match online form Confusing language Application assistance unavailable Application assistance inconsistent

  5. Eligibility Determination Barriers Data entry errors Lost application Processing delays Outreach CBMS makes incorrect determination Or sends conflicting notices Eligibility Determination Family must appeal to correct technician errors

  6. Enrollment Barriers CBMS and MMIS disconnect Outreach CHP+ kids get “stuck” and are never enrolled in an MCO Eligibility Determination Enrollment

  7. Renewal Barriers “Statement of Facts” confusing Outreach Coverage dropped for eligible kids Eligibility Determination Enrollment Renewal

  8. 78,000 Eligible Kids Uninsured

  9. Colorado Can Do Better

  10. Colorado Can Do Better

  11. We Can Start Right Now • The Top 5 • Leverage Community Partnerships • Simplify and Standardize Income Rules • Fix the Computers • Get the Data • Keep Eligible Kids Covered With Phone / Online Renewals • 20 Specific Action Steps • 5 Legislative • 5 Regulatory • 10 Administrative

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