The Process Improvement Center assists state and local eligibility offices in
streamlining their application and renewal processes for Medicaid and SCHIP. In
addition to having a solid, practical foundation in these programs, our staff
has experience and knowledge in process improvement methodology and group
facilitation. The center makes use of a Process Improvement Collaborative to
affect Medicaid and SCHIP eligibility process improvement.
A Collaborative is a dynamic and powerful 12-month commitment between the
technical experts of our Process Improvement Center and up to 15 teams of
public program and related health care providers who share the common goal of
rapidly achieving Medicaid and SCHIP eligibility process improvements. The
center's Collaborative includes two Action Periods strategically placed between
three Learning Sessions.
Center staff, supplemented with contract faculty who are subject matter
experts, instructs the participants during the Learning Sessions utilizing the
effective model known as the Plan-Do-Study-Act (PDSA) approach to problem
solving.1 This widely recognized process for continual improvement
entails:
Plan- Develop a plan for improving the quality of a process.
Do- Execute the plan, first on a small scale.
Study- Evaluate feedback to confirm or to adjust the plan.
Act- Make the plan permanent or study the adjustments.
During the Action Periods, the teams apply their new knowledge and skills in
their respective work environments. Teams collect data with small scale testing
of improvements and then analyze and refine the modifications in subsequent
Learning Sessions. Center staff and the Collaborative faculty are intimately
involved with the Collaborative team and provide technical assistance to the
participants via conference calls and an interactive website.
Through the sharing of ideas and experiences, the Collaborative is instrumental
in changing the culture of the eligibility office, transforming it into an
efficient and effective agency for lower-income children and adults. Cheryl
Camillo of the Centers for Medicare & Medicaid Services at the U.S.
Department of Health and Human Services confirms the power of the Collaborative
stating, "The Collaborative is not only a tool to maximize enrollment but also
a way to revitalize government."
The Process Improvement Center also provides onsite technical assistance.
Professional consultants provide realistic advice and guidance in the analysis
of processes, identification of modifications and improvements and design of
small scale testing of adjustments, while documenting and evaluating results.
1. Gerald J. Langley, Kevin N. Nolan, Thomas W. Nolan, Clifford L. Norman and
Lloyd P. Provost, The Improvement Guide, (San Francisco, CA: Jossey-Bass,
1996), 6-11.
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