#USA #Miami #Medicaid #Healthy Together #Community Engagement

Introduction

In a significant move to transform Medicaid operations, Healthy Together has introduced its Community Engagement Verification System as a Service (CEV SaaS). This innovative solution aims to help state Medicaid agencies comply with the community engagement requirements of H.R. 1 swiftly and efficiently. The challenges of fragmented verification processes often burden agencies with administrative inefficiencies and risks. Healthy Together's new offering promises a modernized, scalable approach to address these issues.

The Need for Change

Medicaid programs are grappling with outdated systems that hinder the verification of income, work activities, and participant statuses. The existing processes are labor-intensive and prone to errors, resulting in significant administrative burdens for agencies. Healthy Together's newly launched service strategically addresses these concerns, offering an API-driven system built on their sophisticated Polycore platform.

This platform facilitates rapid and accurate verification processes, allowing agencies to navigate the complexities of modern Medicaid enrollment with ease. Recognizing the urgent deadlines imposed by new modernization expectations from the Centers for Medicare & Medicaid Services (CMS), the need for an efficient solution like CEV SaaS is more critical than ever.

Features of CEV SaaS

Healthy Together's CEV SaaS is designed to complement existing Eligibility and Enrollment (EE) systems, ensuring a seamless integration that avoids the disruptive impacts of a complete system overhaul. Here are some key features that stand out:

1. Configurable Eligibility and Verification Rules: The system can adapt to the unique policy requirements of each state. This flexibility ensures that states can implement customized solutions that meet their specific needs without lengthy modifications.

2. Mobile-First Digital Experience: This feature enhances engagements by providing intuitive portals for users. Participants and staff can easily access information, making verification processes clear and straightforward.

3. AI-Assisted Reviews: By introducing AI into the workflow, the system alleviates manual workloads. It prioritizes and flags cases to expedite resolutions, ultimately reducing backlogs that commonly plague Medicaid agencies.

4. Automated Data Validation: The system verifies essential information like employment and education automatically, minimizing errors that typically arise from manual inputs.

5. Proactive Communication Tools: CEV SaaS incorporates tools for automated reminders and secure messaging, keeping participants engaged and informed about their compliance requirements.

Operational Impact

The underlying components of the CEV SaaS are already operational in several state programs, demonstrating its capability to support various Health and Human Services initiatives. Healthy Together's approach provides a robust foundation that can adapt to emerging policy requirements, streamline administrative functions, and improve participant experiences.

CEO Jared Allgood emphasized the importance of having solutions that can be deployed quickly and operate seamlessly with existing infrastructures. The CEV system not only facilitates compliance with HR1 mandates but also reduces operational overhead.

Conclusion

Healthy Together's Community Engagement Verification System presents a vital evolution in the world of Medicaid management. By reducing administrative burdens and enhancing operational transparency, it empowers agencies to focus on delivering better outcomes for the communities they serve. As states grapple with the challenges of modernizing their Medicaid programs, Healthy Together's innovative solution stands out as a beacon of efficiency and effectiveness.

For more information about the CEV System and how it can transform Medicaid operations, visit Healthy Together's website.