Health-e-App Shows Web’s Streamlining Potential, Smith Says
Health-e-App, the online enrollment program for children and pregnant women eligible for Medi-Cal and Healthy Families, shows the "enormous potential for the Internet to modernize and simplify government functions," California HealthCare Foundation President and CEO Mark Smith said last week at the First National Health Policy Conference in Washington, D.C., sponsored by Health Affairs and the Academy for Health Services Research and Health Policy. Unveiled last month, Health-e-App was developed by CHCF in partnership with the California Health and Human Services Agency and the Medi-Cal Policy Institute as a consumer-friendly approach to increase enrollment. The program relies on certified application assisters, people the government pays to help enrollees fill out online applications. Smith said, "Health-e-App replaces the paper process that is fraught with errors and delays. It reduces the time to enroll someone from six days to six minutes, offers real-time eligibility determination, real-time selection of physicians and plan, real-time submission of electronic signatures, and soon ... real-time payment of the first month's premium." Preliminary results from the three-week pilot in San Diego County include:
- More than 200 applications from six test sites were submitted.
- Certified application assisters used wireless modems to submit applications from WIC sites, schools and applicants' homes.
- "Acceptance" of the system by both CAAs and applicants was high.
However, Smith indicated that there are "substantial political, organizational [and] cultural obstacles" for such a program. In working with the government on Health-e-App, CHCF played a unique role by providing both policy and technical expertise. But Smith said that the extensive time and effort required for the project took "an enormous toll on CHCF's staff and productivity." Noting that CHCF's role in Health-e-App extended beyond traditional grantmaking, CHCF Chief Information Officer Sam Karp said, "Foundation staff have contributed policy and technical expertise to [help] the state streamline the application process, primarily through the use of real-time computing. This has taken time to design, build and test, but it is already proving to be at the heart of Health-e-App's overwhelming acceptance." Based on CHCF's experience, Smith advocated the creation of not-for-profit intermediaries with the sole mission of running such programs (Melissa Keefe, California Healthline, 2/6).
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