In January 2010, at the White House Forum on Modernizing Government, President Obama noted that, “Improving the technology our government uses isn’t about having the fanciest bells and whistles on our websites – it’s about how we use the American people’s hard-earned tax dollars to make government work better for them.” Now, six months later, the newly formed Enrollment Workgroup of the Health IT Policy and Standards Committees has begun the discussion of how to bring eligibility determination and enrollment in health and human services programs into the 21^st century.

What we critically need—and what these standards have the promise to support—is an eligibility and enrollment system that will make applying for health insurance and other human service programs as easy as using the Internet to pay your bills or file your income taxes.  It should be possible to apply for programs online, easily obtain the documents and information needed to confirm eligibility, and re-use this information to apply for a variety of programs, and re-certify your eligibility when the time comes. We need your help to uncover the examples, insights and best practices that will make this effort successful.

As background, the Enrollment Workgroup, authorized by the Affordable Care Act (ACA), has been tasked to recommend a set of standards to facilitate enrollment in Federal and state health and human services programs, including standards for:

• Electronic matching across state and Federal data
• Retrieval and submission of electronic documentation for verification
• Re-use of eligibility information
• Capability for individuals to maintain eligibility information online
• Notification of eligibility

To follow up on the June 14^th Enrollment Workgroup’s first meeting and public hearing and to elicit further public comment, the FACA Blog is open for comments until July 1st. Comments can be submitted online on the blog website or emailed to: judy.sparrow@hhs.gov (use “enrollment workgroup” in header)

Specifically, the Workgroup would like public comment on:

(1) Federal, state, local or tribal government initiatives to simplify and streamline eligibility and enrollment in health and human services programs.

We would appreciate your insights on: 

• How should this work support health reform goals, including simplified and streamlined eligibility?
• What standards are currently being used by state health and human services programs to determine eligibility?
• In what areas would additional standards create clear progress towards the goal of a seamless eligibility system for consumers?
• What standards or technology principles would enable rapid innovation in this space?

You might also describe your efforts, including use of standards and technology to simplify eligibility and enrollment, for: 

• Front end check of eligibility/enrollment across multiple programs:
  • How do you check eligibility/enrollment across programs at the front end? Which programs are included?  Standards used? 
• Approach and standards for data linking/matching? Is the matching probabilistic? What level of accuracy is required? Collecting information to determine multiple program eligibility
  • What interfaces do you use to obtain electronic verification information? What standards used?
  • Consumer entry of eligibility information, what data elements? Consumer authentication?
  • What standards are used for messaging? 

(2) Alternatively, if you are not in the healthcare sector, how have you solved challenges similar to those found in simplifying and streamlining eligibility and enrollment?  In other words, how can we move towards 21^st century practices? 

• For example, share your perspectives on:
  • Opportunity to move towards a web-services model
  • Viability of a platform-based or enterprise service approach
  • Role of consumer in managing own data
  • Where we need standards to accelerate progress and consumer participation

Your responses will help form the agenda for the on-going work of the Enrollment Workgroup, and assist us as we work toward a September 30^th deliverable deadline as mandated by ACA.

Thank you for your contribution!
– Aneesh Chopra, Chair, Enrollment Workgroup
– Sam Karp, Co-Chair, Enrollment Workgroup
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To make comments directly on the official FACA blog site, click here.