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The BadgerCare Plus Evaluation Team
Prepared for AcademyHealth, 6/2011
   Am I Eligible?
    Anyone can submit minimal information on their household
    and receive feedback on whether they might be eligible for
    health care, nutrition or child care supplements, prescription
    drug assistance, energy assistance or tax credits.

   Apply for Benefits
    Submit application for BadgerCare Plus, Medicaid,
    FoodShare, child care and/or the Family Planning Waiver
    online. However, other steps must be taken for the process to
    be completed.
   ACCESS

   Mail-in

   Walk-in

   Phone
   What % of applications are received through ACCESS?
     Are there differences in the socio-economic status of those that
      use ACCESS versus other methods of application?
   Target Efficiency of ACCESS: Is ACCESS more or less
    likely than other methods to attract applicants who are
    ultimately determined to be eligible for public insurance?
   Application and Eligibility Spillover: Does ACCESS
    promote greater likelihood of applying to other social
    programs? What are the rates of eligibility determination
    among “spillover” applications generated by ACCESS
    relative to other methods?
   State contractor Deloitte selected a sample of those who
    applied for Health Insurance from January 2008 to October
    2010 through all methods.

   UW-PHI limited the sample to BC+ Child and Caretaker
    applications through November 2009 so we could match to the
    CARES demographic data we had at the time. CARES is the
    state’s eligibility system for BadgerCare Plus.

   We selected the oldest person listed in the case for individual
    demographic categories, typically a parent.
   Percent of Applications by Method
                       4%



                 17%
                                    ACCESS
                                    Walk-in
                18%         62%     Mail-in
                                    Phone
   Percent Determined Eligible for BC+ by
    Method
                                      100%
                                             87%
                                                      83%
                                      90%
      % determined eligible for BC+




                                                                        77%
                                      80%
                                                                                 69%
                                      70%
                                      60%
                                      50%
                                      40%
                                      30%
                                      20%
                                      10%
                                       0%
                                             Phone   Walk-in           Mail-in   ACCESS

                                                        Application method
   SES by Method
                    Application Method by Income

    100%                               85%
     80%                                                           ACCESS
           56%
     60%                                                           Walk-in
     40%                                                           Mail-in
                 22% 18%
     20%                      4%             5%   8%               Phone
                                                         2%
     0%
                 < 150% FPL                >= 150% FPL


                        Note: similar pattern emerges when the sample is
                        stratified by other potential markers of vulnerability
                        (primary language, citizenship status, rural status,
                        gender)
   Application Spillover by Method
      80%
                                 72% 72%
      70%
                    60%    63%
      60%                                                         53%
                51%                                             46%
      50%
                                                             41%
            38%
      40%
                                                                            Jan08-Jun08
      30%
                                                                            Jul08-Dec08
                                                       16%
      20%                                                                   Jan09-Nov09
                                                  6%
      10%                                    4%

      0%
               ACCESS         Walk-in         Mail-in         Phone
       Application spillover = % of BC+ applicants also applying for FoodShare
   Eligible Spillover by Method

      90%                                                        82%
                                     74%             72%      75% 78%
      80%
                              72% 72%
                                               63%
      70%
                                                       60%
      60%
                 50%52%
      50%     42%
      40%                                                                      Jan08-Jun08
      30%                                                                      Jul08-Dec08
      20%                                                                      Jan09-Nov09
      10%
       0%
                  ACCESS          Walk-in         Mail-in         Phone
      Eligible spillover = % of BC+ applicants applying for FoodShare (FS) who are
      determined eligible for FS
   Wisconsin awarded federal Early Innovator grant to be
    used to expand ACCESS platform for planned private
    health insurance exchanges
   Governor’s proposed biennial budget eliminates county-
    based walk-in services, instead relying almost exclusively
    on ACCESS
     Has generated considerable concern among advocate groups

   Currently, ACCESS requires all submitted applications to
    be reviewed by a caseworker to verify and review
    information submitted. Cost/benefit analysis?
   Data, graphs, and some written sections taken from two issue briefs: “The
    Target Efficiency of Online Medicaid/CHIP Enrollment: An
    Evaluation of Wisconsin’s ACCESS Internet Portal”- Leininger,
    Friedsam, Voskuil, DeLeire. Published by the Robert Wood Johnson
    Foundation & “Online Application for Medicaid and BadgerCare: How
    Efficient Relative to Other Application Venues?”



Thanks to the Robert Wood Johnson Foundation and the Wisconsin
  Department of Health Services for the support.

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Arm2011 oliver(leininger) 6.14.11

  • 1. The BadgerCare Plus Evaluation Team Prepared for AcademyHealth, 6/2011
  • 2.
  • 3. Am I Eligible? Anyone can submit minimal information on their household and receive feedback on whether they might be eligible for health care, nutrition or child care supplements, prescription drug assistance, energy assistance or tax credits.  Apply for Benefits Submit application for BadgerCare Plus, Medicaid, FoodShare, child care and/or the Family Planning Waiver online. However, other steps must be taken for the process to be completed.
  • 4.
  • 5. ACCESS  Mail-in  Walk-in  Phone
  • 6. What % of applications are received through ACCESS?  Are there differences in the socio-economic status of those that use ACCESS versus other methods of application?  Target Efficiency of ACCESS: Is ACCESS more or less likely than other methods to attract applicants who are ultimately determined to be eligible for public insurance?  Application and Eligibility Spillover: Does ACCESS promote greater likelihood of applying to other social programs? What are the rates of eligibility determination among “spillover” applications generated by ACCESS relative to other methods?
  • 7. State contractor Deloitte selected a sample of those who applied for Health Insurance from January 2008 to October 2010 through all methods.  UW-PHI limited the sample to BC+ Child and Caretaker applications through November 2009 so we could match to the CARES demographic data we had at the time. CARES is the state’s eligibility system for BadgerCare Plus.  We selected the oldest person listed in the case for individual demographic categories, typically a parent.
  • 8. Percent of Applications by Method 4% 17% ACCESS Walk-in 18% 62% Mail-in Phone
  • 9. Percent Determined Eligible for BC+ by Method 100% 87% 83% 90% % determined eligible for BC+ 77% 80% 69% 70% 60% 50% 40% 30% 20% 10% 0% Phone Walk-in Mail-in ACCESS Application method
  • 10. SES by Method Application Method by Income 100% 85% 80% ACCESS 56% 60% Walk-in 40% Mail-in 22% 18% 20% 4% 5% 8% Phone 2% 0% < 150% FPL >= 150% FPL Note: similar pattern emerges when the sample is stratified by other potential markers of vulnerability (primary language, citizenship status, rural status, gender)
  • 11. Application Spillover by Method 80% 72% 72% 70% 60% 63% 60% 53% 51% 46% 50% 41% 38% 40% Jan08-Jun08 30% Jul08-Dec08 16% 20% Jan09-Nov09 6% 10% 4% 0% ACCESS Walk-in Mail-in Phone Application spillover = % of BC+ applicants also applying for FoodShare
  • 12. Eligible Spillover by Method 90% 82% 74% 72% 75% 78% 80% 72% 72% 63% 70% 60% 60% 50%52% 50% 42% 40% Jan08-Jun08 30% Jul08-Dec08 20% Jan09-Nov09 10% 0% ACCESS Walk-in Mail-in Phone Eligible spillover = % of BC+ applicants applying for FoodShare (FS) who are determined eligible for FS
  • 13. Wisconsin awarded federal Early Innovator grant to be used to expand ACCESS platform for planned private health insurance exchanges  Governor’s proposed biennial budget eliminates county- based walk-in services, instead relying almost exclusively on ACCESS  Has generated considerable concern among advocate groups  Currently, ACCESS requires all submitted applications to be reviewed by a caseworker to verify and review information submitted. Cost/benefit analysis?
  • 14. Data, graphs, and some written sections taken from two issue briefs: “The Target Efficiency of Online Medicaid/CHIP Enrollment: An Evaluation of Wisconsin’s ACCESS Internet Portal”- Leininger, Friedsam, Voskuil, DeLeire. Published by the Robert Wood Johnson Foundation & “Online Application for Medicaid and BadgerCare: How Efficient Relative to Other Application Venues?” Thanks to the Robert Wood Johnson Foundation and the Wisconsin Department of Health Services for the support.