Kentucky’s New Take on Medicaid Expansion

Published: June 01, 2018

SLED Market AnalysisHealth CareHealth ITHealth ServicesInformation TechnologyJobs Programs and Workforce InvestmentKENTUCKYMedicaid Management Information SystemsSocial ServicesSocial ServicesSupplemental Nutrition Assistance ProgramTemporary Assistance for Needy Families

Brief analysis on procurement trends for the implementation of work and community engagement requirements for the Medicaid population.

The Kentucky Finance and Administration Cabinet On Behalf Of Cabinet for Health and Family Services (CHFS) released a Data Analytics and Enterprise Data Warehouse (EDW) RFP for the Kentucky program, Helping to Engage and Achieve Long Term Health (HEALTH). Kentucky HEALTH is a result of the Section 1115 Demonstration Waiver, an initiative the Centers for Medicare and Medicaid (CMS) approved in January 2018 which allows states to design work and community engagement requirements around adult Medicaid beneficiaries that are non-elderly, non-pregnant, and that are eligible for Medicaid on a basis other than disability. The goal of Kentucky HEALTH is to leverage federal funding to improve access to health, educational, financial, and professional development resources that can help families and communities.

This procurement is significant because it is not an RFP for the general Kentucky Medicaid population, but the new population that falls under the Medicaid expansion. This new population will have different requirements than the traditional Medicaid population of low income children, seniors, pregnant, or disabled citizens. Kentucky is the first state to require some individuals enrolled in Medicaid to actively participate in education, job training, substance use disorder treatment, employment, or volunteering activities as a condition of eligibility. This program may be a trend we will see replicated in other states that implemented work requirements for Medicaid beneficiaries such as New Hampshire, Indiana, and Arkansas. As these states begin implementing work and community engagement requirements on the expanded Medicaid population, specifically able bodied working age beneficiaries and their families, it is likely they will have a new set of business needs including but not limited to data analytics, eligibility systems, enrollment brokers, enterprise data warehouses, call centers, workforce training programs, and case management systems.