Susan Kern is a program specialist for the Colorado Department of Human Services.
A project funded by the Colorado Health Foundation is making life easier for children and families who rely on public health insurance plans. It's also helping workers who process the programs work more efficiently than ever before.
The Colorado Eligibility Process Improvement Collaborative aims to improve the efficiency, effectiveness and quality of processes for public health programs. CEPIC is a partnership of the Colorado Department of Health Care Policy and Financing, the Colorado Department of Human Services and 15 local county departments. The project was made possible through a $575,000 grant from the Foundation.
CEPIC aims to reduce application processing times, increase worker satisfaction, and increase the number of eligible (but not enrolled) applicants into Medicaid and Child Health Plan Plus (CHP+). But before that could be accomplished, participants needed to identify barriers that hampered the process:
- Clients were not getting the timely service they expected
- The processes lacked structure
- There were too many applications left at front desk without an interview appointment
- Only 9 percent of the applications submitted were complete at the time of interview
To address these problems, participants tested Plan-Do-Study-Act (PDSA) cycles on a small scale. PDSA is shorthand for testing a change by developing a plan to test the change (Plan), carrying out the test (Do), observing and learning from the consequences (Study), and determining what modifications should be made to the test (Act). CEPIC participants tested and implemented strategies to achieve significant breakthroughs on reducing application processing time.
The results of the collaborative were impressive. Counties reported permanent changes to their workflow to improve processing times. One county reduced its maximum application processing time from 48 days to 26 days. This resulted in clients receiving their needed benefits 22 days earlier, an improvement vital to people waiting for basic medical or financial benefits.
Many participants reported the PDSA model was expanded from financial and medical benefit divisions to entire county processes. Counties reported the CEPIC collaborative resulted in exceptional customer service. Some counties were reporting same-day processing of ready-to-work applications. Staff morale among participating counties improved substantially. One technician reported:
"With this new process, I remembered why I got into this line of work. I can meet with a client and have their benefits to them by 4 p.m. the same day. Clients will actually hug me. I do not have applications piled on my desk and my phone calls have been reduced from four or five per hour to maybe one per day. I can go home and leave the job at work...no more taking the problems home with me."