The Eligibility 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 Eligibility 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:
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 Eligibility 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.
1Gerald 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.
