Celebrating 25 Years of Pioneering Social Services Enrollment Excellence

July 27, 2021 Carla Salario

Back in 1996, state health and human services agencies were struggling to adapt to rising requirements to migrate individuals and families from traditional insurance providers to emerging managed care programs supported under Medicaid. State social services agencies were in need of solutions to help beneficiaries apply, and sign up for one of the managed care programs offered under Medicaid.

To address the emerging needs, Conduent launched our Enrollment Broker solution, one of the very first designed to help public sector agencies get people signed up for state-run Medicaid, along with other health and human services programs.

In one northeastern state, a concentrated outreach, education, and enrollment campaign was implemented co-locating Conduent enrollment counselors at state social services agency offices to conduct training and enroll beneficiaries, produce educational videos, and subcontract with local action groups to conduct monthly training sessions statewide. At the time, the state’s enrollment broker operation was one of the first to offer telephone-based managed care enrollment without requiring a signed form. The program was implemented on time and within budget, and during its first year of operation it achieved a very high 90% voluntary enrollment rate.  

At that time, it took as long as 60 to 90 days for people to choose a managed care plan. Using Conduent’s Enrollment Broker solution, state social services agencies reduced costs and streamlined the process of enrolling constituents in managed care and/or state-run healthcare programs by giving guidance to individuals to help them choose a healthcare plan and participating primary care provider.

Separately, Conduent helped another mid-Atlantic state quickly implement a statewide call center to respond to health insurance questions. We successfully amended our MMIS contract to implement call center operations and help the state’s social services agency comply with statewide call center and telephonic application requirements included in the Affordable Care Act (ACA). Although the timeframe was very short for this particular implementation, we expanded two call center locations and met the aggressive ‘go-live’ date for open enrollment.

Today, we work as a crucial link between beneficiaries and the managed care delivery systems used to better serve each constituent’s health needs. Our approach across all health and human services enrollment programs is to work closely with state agency clients to reach the right target audience using the channel of their audience’s choice.

During the recent global pandemic, for example, a growing number of people chose to apply for all types of social services online. According to a recent (May 2021) U.S. Department of Agriculture Food and Nutrition Service research study, 46 of 53 state agencies now accept online applications for USDA Supplemental Nutrition Assistance Program (SNAP) benefits from new applicants, and 33 state agencies allow SNAP participants to re-certify to renew their benefits online. All states reported that online applications helped improve customer service.

In the future, our goal remains the same -- to meet our government agency clients’ top priorities and expedite application and enrollment processing. To this end, we will leverage our innovative solutions and methods, from online portals and cloud-driven advances, to actionable analytics, to help state agencies provide better customer relationship management (CRM), case management and workflow management in a single, comprehensive Conduent platform that will seamlessly connect front office contact centers with back office eligibility and enrollment operations.

Our solutions integrate cases across differing systems to automate data input, rules and processes, and deliver a 360 degree view of each individual case. At the same time, intelligent, guided interactions driven by AI, combined with machine learning, help to anticipate constituent needs based on each person’s circumstance. Our clients need modern eligibility and enrollment solutions that will increase accuracy, speed and efficiency, while reducing manual interventions where possible.

For four decades, we have helped government agencies implement and manage solutions that meet health and human services program needs. We will continue to meet our government agency clients’ mission priorities to expedite application and enrollment processing and better serve families and individuals in need.

About the Author

Carla Salario

Carla Salario is Director of Client Solutions, Government Payment and Eligibility Solutions, Conduent

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