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NASCIO AwardsHealth-e-Arizona

public health insurance programs, thus facilitating enrollment into health care services and improving access to health care for the medically underserved, uninsured population of Arizona.

The solution involves three previously untested strategies in Arizona.

1. Collaboration between the public and private sectors. This project brings together organizations which are the major stakeholders in the problem to be addressed, and which have not previously worked together in this capacity. They are:

El Rio Health Center. A 501(c)(3) not for profit community health center located in Tucson, Arizona, that provides primary health care services to 60,000 active patients, who are mostly low income and/or uninsured.

Community Health Center Collaborative Ventures (CHCCV). A 501(c)(3) not for profit formed by the Federally Qualified Health Centers (FQHC’s) of Arizona to promote and facilitate the delivery of community based health care to the medically underserved in the state.

Arizona Association of Community Health Centers (AACHC). A 501(c)(3) not for profit Primary Care Association representing the Community Health Centers (CHC’s)/FQHC’s of Arizona.

St. Luke Charitable Health Foundation. A charitable foundation located in Phoenix, Arizona, representing small businesses around the state.

Arizona Health Care Cost Containment System Administration (AHCCCSA). The Administration of Arizona’s Medicaid Program.

Arizona Department of Economic Security Administration (DES). The Administration of the Department of Economic Security in Arizona.

2. Use of digital network technology for the Medicaid application process for Arizona government health insurance programs. As noted earlier, a principal barrier to enrolling in public health insurance is the cumbersome application process. The proposed technological solution enables a complete and accurate application to be submitted to AHCCCS or DES, the two governmental agencies who determine eligibility for public health insurance programs in the State of Arizona, via the Internet. This automated, computerized system fully captures the data needed to determine enrollment, as well as the supporting documentation and electronic signatures required to complete the eligibility determination, and submits them to the appropriate agency for review. This replaces the current manual system which is fraught with delays and errors.

3. Strategic placement of the proposed technology. The automated application system will gradually be placed at three types of locations where the uninsured are already located and/or seeking health care services. They are:

Federally Qualified Health Centers (FQHC’s) where the majority of low income uninsured persons are already seeking their primary health care services.

Hospital Emergency Rooms and Outpatient Centers, where uninsured persons often present to receive health care services which can no longer be postponed.

Small Businesses. (Eight out of ten uninsured are from working families. Approximately half of the people without health insurance work for small businesses with up to 99 employees.)

INNOVATION

The innovative aspects of this project are threefold. First, the project is based on a computerized eligibility application already developed and in use in California by the California Health Care Initiative for use with the California SCHIP program. With some modifications, the project makes use of the California application, called Health-e-App, to process applications in Arizona. However, the innovation lies in the use of the application in this project. While in California, the application is designed only for the SCHIP program, the Arizona project uses the application to process a universal application, which is valid

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