Simplifying Medicaid Processes Can Increase Efficiency and Improve the User Experience

Introduction

Read the full issue brief.

Medicaid is a critical economic and health program in West Virginia, serving over 616,000 people, including children, seniors, low-income adults, pregnant and postpartum women, persons with disabilities, and more. In addition to being the main source of health access for over one-third of the state’s population, Medicaid covers the majority of births and more than three-fourths of long-term care, is the primary health insurance for over 50 percent of children, and provides substance use treatment
and a range of other services in West Virginia, ensuring access to health care for our most vulnerable populations. Medicaid’s flexibility and reach has never been more clear than during the pandemic recession, when it provided health coverage for tens of thousands of West Virginians who lost other health coverage. Nevertheless, Medicaid and those who rely on it are often faced with stigmatizing language, mountains of bureaucratic hurdles, and harmful policy proposals.

Over the last year and a half, the West Virginia Center on Budget and Policy (WVCBP) has worked in partnership with West Virginians for Affordable Health Care (WVAHC) on a listening project to identify ways to enhance the Medicaid experience for West Virginians. Over the course of this project, our team has learned more about the Medicaid process through the experiences of those who utilize and administer the program, including state officials and legislators, health care providers and
advocates, and — most importantly — Medicaid enrollees and people who are eligible but not enrolled in the program.

During this project, the WVCBP and WVAHC teams interviewed a combined 25 people categorized as either Medicaid stakeholders or people with lived Medicaid experience. These interactions led to the identification of several patterns critical to understanding the role of Medicaid in the Mountain State, and how it can better serve enrollees. While the project is ongoing, our preliminary findings can help stakeholders and policymakers craft policy priorities that can critically improve Medicaid’s efficacy.

This brief will outline several policy recommendations derived from the project that can address our findings and improve the Medicaid program and health outcomes overall.

Key Findings

• While Medicaid covers over one-third of West Virginia residents and has wide-ranging positive impacts on our state’s economy, stigmatization of the program and its recipients remains prevalent.
• Overall, the largest barriers to accessing Medicaid indicated by respondents were lack of internet access and difficulty reaching Department of Health and Human Resources (DHHR) staff by phone.
• West Virginia is one of just four states in which a Medicaid application cannot be fully completed online in a single setting.
• West Virginia is one of just nine states that fails to offer telephonic signatures for renewal applications, thus increasing paperwork for Medicaid recipients and DHHR staff because renewals cannot be fully completed over the phone.
• Streamlining of Medicaid enrollment and renewal processes can save time and reduce workload for DHHR staff, particularly as the COVID-19 public health emergency ends and increases administrative workload.