Spotlight on Express Lane Eligibility (ELE): A Tool to Improve Enrollment and Renewal
Spotlight on Express Lane Eligibility (ELE): A Tool to Improve Enrollment and Renewal
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DOI：
10.1016/j.acap.2015.02.010
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发表时间：
2015-05-01
影响因子：
3.1
通讯作者：
Hoag, Sheila D.
中科院分区：
文献类型：
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作者：
Hoag, Sheila D.
目的：我们研究了2009年儿童健康保险计划再授权法案（CMPRA）推出的一项新的简化政策，快速通道资格（ELE），以了解ELE对注册，续期和管理成本的影响。方法：从2012年1月开始，持续到2013年6月，我们对8个州的38名州行政人员和工作人员进行了两轮电话采访，这些州在医疗补助计划、儿童健康保险计划（CHIP）或两者中实施了tLE;我们还在这些州进行了个案研究，进行了136次面对面访谈。我们收集的行政数据，通过ELE方法处理的入学和续期从8 state.RESULTS：ELE采用不同的方式，采用的方法影响有多少孩子服务和行政储蓄。自动ELE流程，使各州能够使用合作机构的资格调查结果自动注册或续签儿童，为大多数儿童提供服务，并平均每年节省100万美元的行政费用。鉴于续订案件量的大小和续订的经常性，使用ELE续订持有大量的承诺，为行政储蓄和保持儿童covered.CONCLUSIONS：自动ELE流程是使用ELE的最佳实践。然而，由于国会尚未将ELE作为一项永久性的政策选择，因此不鼓励各州采用这种更有效的资格确定和重新确定方法。使ELE永久化将支持已经采取该政策的州;此外，如果CHIP在2015年9月30日之后没有得到资助，ELE可以支持儿童向医疗补助或交换的过渡。
OBJECTIVE: We examine a new simplification policy, Express Lane Eligibility (ELE), introduced by the Children's Health Insurance Program Reauthorization Act of 2009 (CMPRA), to understand ELE's effects on enrollment, renewal, and administrative costs.METHODS: Beginning in January 2012 and lasting through June 2013, we conducted 2 rounds of phone interviews with 38 state administrators and staff in 8 states that implemented tLE in Medicaid, Children's Health Insurance Program (CHIP), or both; we also conducted case studies in these same states, resulting in 136 in-person interviews. We collected administrative data on enrollments and renewals processed through ELE methods from the 8 states.RESULTS: ELE was adopted in different ways; the method of adoption influenced how many children were served and administrative savings. Automatic ELE processes, which enable states to use eligibility findings from partner agencies to automatically enroll or renew children, serve the most children and generate, on average, $1 million annually in administrative savings. Given the size of renewal caseloads and the recurring nature of renewal, using ELE for renewals holds substantial promise for administrative savings and keeping children covered.CONCLUSIONS: Automatic ELE processes are a best practice for using ELE. However, because Congress has not yet made ELE a permanent policy option, states are discouraged from adopting this more efficient method of eligibility determination and redeterminations. Making ELE permanent would support states that have already adopted the policy; in addition, ELE could support the transition of children to Medicaid or exchanges should CHIP not be funded after September 30, 2015.