New Funding Opportunities for Interoperability

Now is a great time to be a health and human services government leader committed to breaking down service silos to create a true system of care, at least for eligibility determination.  The Patient Protection and Affordable Care Act has put States on the fast track to developing new eligibility systems for Medicaid in order to keep up with the Health Insurance Exchange requirements of the Affordable Care Act.  To build these new eligibility systems, States are taking advantage of an enhanced Federal Funding Participation rate of 90% for Medicaid Eligibility systems.  


In the past this would have meant that Medicaid would build new systems and then later, new systems would be built for other programs.  States would then pay for more than one system to conduct much the same business processes (i.e. eligibility determination) for a client population that has substantial overlap with the Medicaid population.  States that would have wanted a single system would have had to cost allocate the expense among all participating programs, none of which are reimbursed at 90% creating a major financial disincentive for building a comprehensive system.  But now there is a change, a time-limited exception to the need to cost allocate for the components that Medicaid needs but also can be utilized for other human services programs. This makes for smart government.  Timing is very short to accomplish this – the eligibility systems need to be built prior to the end of 2015.  However, at least one major barrier has been removed for those states that are properly positioned and able to commit the time and resources to take advantage of this opportunity.  


Are any States planning to take full advantage of the newly allowed cost allocation exceptions together with the 90% Federal funding for Medicaid eligibility to create systems which can conduct eligibility determination across multiple health and human services programs?    

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