Resources and Toolkits

Piece on the need for states to work quickly to build Medicaid systems that serve clients efficiently and impactfully, with information related to CMS’s Interim Final Rule

Webinar session to discuss Medicaid unwinding lessons, strategies to coordinate work requirement and ex parte renewals, and methods toward designing flexible, efficient, and sustainable systems. Passcode: ^m3Q+Fuz

Open-source community engagement reporting (OSCER) tool enables states to achieve work requirements compliance automatically using client and ex parte data, or otherwise provide link for manual certification or exemption application. Provides staff with case management and reporting tools, and sends results to state Medicaid agencies for issuance or disenrollment.

Guide on how state agencies can develop legible and flexible metrics to assess implementation of new work requirements, outlining how to build, capture, and effectively utilize metrics to monitor impact for operational awareness and decisionmaking.

Implementation-oriented framework to support states with adapting to community engagement/work requirements. Features overview of “look back” period and four-step compliance flow including: checking for automatic hardship, screening for exemptions, checking for participation, and allowing for requestable hardship.

Outlines cases in which generative AI can be appropriately deployed by grounding use in human-centered problem statements. Highlights practical application such as data extraction, summarization, and entity resolution to reduce caseworker burden while maintaining responsible oversight.

Guide explaining automatic benefit notice generation process while walking through common underlying system errors (e.g. missing or incorrect information) providing insight on how back-end design decisions cause these issues. Provides strategies to improve notice process and output such as targeted questions on system logic, workarounds for caseworkers, and structural reform through data flow, boilerplate language,…

Guide to provide states with policy and technical strategies to reduce procedural terminations under Medicaid work requirements, including simplifying verification processes, mitigating automation risks, managing vendor

Repository of resources for state administrators to support the implementation of work requirement policies through overview of implications and recommendations of smart system designs and processes.

Outlines four proactive strategies to design resilient and adaptable technical systems including feature flags, modularity, configurability, and phased approaches.