Market Brief: Integrated Eligibility Systems (IES)

Published: November 30, 2016

Health CareSocial Services

Integrated eligibility systems, which facilitate the application and processing of benefits for multiple health and human services programs, have an average contract value of $75 million, indicating lucrative business opportunities for IT vendors.

States have long recognized the need to integrate health and human services eligibility and enrollment systems to make it easier for clients to apply for benefits and for caseworkers to process applications. The Affordable Care Act spurred this process by requiring states to integrate their Medicaid eligibility systems with the new health insurance exchanges. Now that 90/10 funding has been made permanent, states have the financial resources to continue integrating their health and human services eligibility systems in order to save both time and money. This report provides a national overview of state progress towards building integrated eligibility systems, highlights innovative procurement trends, and directs vendors to states that are seeking vendor assistance with the development or continued maintenance and operation of their IES systems.
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