Technology Tuesdays: What a New Year’s Resolution Could Do for Your State’s IT Systems

By Ani Fete

This blog entry is part of Enroll America’s Technology Tuesdays blog series.

It’s no surprise that the number one New Year’s resolution in the United States is to get in shape. After all of the Thanksgiving turkey and office cookie exchanges, we often feel sluggish by the end of December. The stress of gift shopping, holiday parties, and decorating means there’s no time to exercise. So, beginning January 1st, millions of Americans will take on the difficult challenge of shedding pounds and getting healthy after neglecting their health during the demanding holiday season.

So what does this all have to do with IT systems?

Many public programs around the country operate under “legacy” IT enrollment and eligibility systems that are often old, sluggish, or obsolete. Due to the demands on state budgets and ever-changing policy priorities, these systems have been neglected for years—and sometimes decades—which means they often contribute to very inefficient and ineffective processes that leave eligible individuals without benefits. A recent article in Stateline tells the story of the Texas food assistance program (SNAP, formerly called Food Stamps) that, just two years ago, ranked last in the nation for timely application processing and eligibility determinations. Years of neglect created a processing backlog that left some Texas families waiting as long as six months to find out if they were eligible to receive food assistance. However, the state now ranks near the top for timely processing. 

How did Texas shape up and go from the bottom to the top in less than a year?

Under the leadership of the Health and Human Services Commissioner and his IT Director, Texas took on the significant challenge of turning its flabby IT system into a lean processing machine. Leaders made several significant improvements to the workflow process, starting by fixing glitches in the state’s new IT system, known as TIERS, and adding significant server capacity to allow for speedy processing. State leaders addressed critical staff shortages, implemented meaningful staff trainings for the new system, added phone lines for improved customer service, and created reporting capabilities to monitor and respond to system failures in a timely manner. Perhaps most importantly, the state worked with eligibility workers and managers to build support for the new system and the significant changes taking place in their day-to-day work flow as a result. Though Texas’s experience underscores the need to maintain adequate staffing levels, improved systems allow the state to get the work done—accurately and on time—with fewer workers than under the old system.

According to the article, the Texas story demonstrates “how a relentless focus on results can get even the most overburdened bureaucracy to catch up on its work.” What if every state accepted a New Year’s challenge to streamline and strengthen its IT systems for determining eligibility in health coverage? Many states face significant backlogs, budget cuts, and staff turnover. However, Texas’s success amidst the same struggles shows that hard work and focus can pay off with the right leadership, drive, and support. And, to motivate states to take on this challenge, federal funding is available. States can receive 90 percent federal matching funds for state investments in Medicaid IT systems, and exchange establishment grants that are available until June 29, 2012, can help states develop the IT infrastructure they need to support their exchange. With this financial support, shaping up a state’s IT systems is a New Year’s challenge worth embracing. 

Special thanks to Anne Dunkelberg and Celia Cole from the Center for Public Policy Priorities for their assistance with this blog.


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