Government Research Reports

State Integrated Eligibility Systems, 2012 (Jun 2012)

Federal health care reforms, such as health benefits exchanges, and an enhanced federal financial participation (FFP) formula are driving integrated eligibility system modernization.

Description

The Patient Protection and Affordable Care Act of 2010 (ACA) initiated a wide-ranging round of modernization for integrated eligibility systems that bridge various health (i.e., Medicaid/SCHIP) and social services systems.

Primary drivers include:

• Streamlined enrollment for Medicaid, SCHIP, and health insurance
• Expanded Medicaid coverage up to 133% of the federal poverty level
• Real-time verification of state data with federal systems

To facilitate these changes, federal financial participation (FFP) has been increased to a 90/10 split that expires at the end of 2015.

Forty-nine states (plus DC) have already initiated some level of planning for this next round of integration, while several have previously planned implementations underway. This report details eligible integration expenses, architectural drivers, recent implementations, and upcoming opportunities that will define this national effort.

Deltek’s State Integrated Eligibility Systems, 2012 report is ideal for both vendors and agencies looking to gain insight into where integrated eligibility will be headed over what will surely be a five to ten year national effort.

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