Magazine article Policy & Practice

Uncovering Oregon's Path to Integrated Eligibility

Magazine article Policy & Practice

Uncovering Oregon's Path to Integrated Eligibility

Article excerpt

There was no fanfare. There were no reporters. There were no cameras or media.

It was almost as though the day had come and gone and no one noticed. For Oregon, Dec. 15, 2015 marked the first step to uncovering the state's path to integrated eligibility. On this rainy, grey December day, the state's Medicaid agency, the Oregon Health Authority (OHA), launched its new eligibility system known as Oregon Eligibility, or "ONE."

Only two years before, Oregon was in the national spotlight for the failed launch of Cover Oregon, the state-based health insurance exchange. While still embroiled in legal battles over the failure, in November 2014 Oregon shifted to Healthcare.gov--the federally facilitated marketplace, and almost simultaneously launched the 16-month Modified Adjusted Gross Income (MAGI) Medicaid system transfer project to implement ONE.

ONE would bring to Oregon a web-based, state-of-the-art worker portal for workers to determine real-time eligibility for adults who qualify for Medicaid due to income level--a new population eligible as a result of the Affordable Care Act. A self-service applicant portal launched in February 2016, enabling community partners to help Oregonians submit applications and report changes.

Challenged by Oregon's tainted reputation for delivering IT projects, ONE would face political hurdles during implementation, and was affected by the change in several key Oregon leadership positions. These changes in leadership included the governor, state Medicaid director, director at the state's Data Center, and the OHA director.

How did Oregon successfully launch ONE despite these challenges? Here are 10 factors contributing to our success:

1. We transferred an existing system. Oregon transferred and implemented "kynect," Kentucky's system. We chose this system because of the similar Medicaid rules, policies, and system interfaces, and the system closely matched Oregon's needs.

2. We hired a systems integrator. Oregon procured Deloitte Consulting for systems integration services. Deloitte successfully implemented integrated eligibility systems in 23 other states, including the original Kentucky system.

3. We followed project management practices. The business and stakeholder community, technology staff, and consultants strongly supported the use of sound project management techniques and processes.

4. We managed scope tightly. Oregon chose to change policy or business process before technology, when feasible. This principle drove adoption of best-practice business processes already inherent in kynect. …

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