Income verification for means-tested public benefit programs are often complex manual processes that impose a “time tax” on the enrollees and create administrative burden for state employees. Income data is often missing, stale, or inaccurate leading to state programs requiring applicants to manually submit documentation such as paystubs to verify income. To address these challenges, the team is piloting an “income verification as a service” solution that seeks to improve income verification for means-tested programs using a consent-based verification tool. Early testing of a minimum viable product prototype has shown promising results, including reduced time for individuals to complete income verification and decreased caseworker workload. The team is continuing the pilots and evaluating the results.

See the 2024 project evaluation plan to learn about the project measures and methods.

The United States Digital Services (USDS)-led Data Services team is seeking to reduce the administrative burden of navigating Federal programs using data and technology. The team’s work in 2023 focused on improving Federal services used to verify income during application and renewals, as well as providing direct technical assistance to States managing Medicaid renewals during the unwinding of the national Public Health Emergency.

Income verification as a service. Federally funded, State-administered programs like Medicaid, SNAP, and TANF require income verification as an essential part of eligibility determinations. Electronic verification processes are currently restricted to serving traditional earners (those that receive an annual Federal W-2 tax form) and lack the means for verifying non-traditional earners (those that receive a form 1099, “gig” laborers, and populations that lack specific types of personal information like Social Security numbers). The Income Verification team partnered with CMS and SNAP to pilot technology improvements to the verification process, which aim to reduce administrative burden, expand electronic verifications for all earners, and provide more efficient and integrated service to enable cross-enrollment and minimize duplication of effort (and costs) by State administrators.

This project aimed to improve the processing of millions of Medicaid renewals at the end of the national Public Health Emergency by increasing the ex parte (automatic) renewal process. Data-driven auto-renewals help eligible individuals remain enrolled with minimal paperwork, reduce processing times, and allow caseworkers to focus on more complex cases. The team provided direct technical assistance to states to identify and remedy IT system errors and weaknesses that resulted in procedural denials and unnecessary administrative burden for beneficiaries. They also guided states in adopting best practices for benefits delivery. As a result of these interventions, over 5 million people have been re-enrolled in Medicaid, saving states more than 2 million hours of caseworker time, and the numbers keep growing as the changes to the state benefit systems have proven to be enduring. The project team is supporting the Center for Medicaid and CHIP Services in building long-term capacity to partner with states.

See the 2024 project evaluation plan to learn about the project measures and methods.

The United States Digital Services (USDS)-led Data Services team is seeking to reduce the administrative burden of navigating Federal programs using data and technology. The team’s work in 2023 focused on improving Federal services used to verify income during application and renewals, as well as providing direct technical assistance to States managing Medicaid renewals during the unwinding of the national Public Health Emergency.

Medicaid renewals rapid response. With the unwinding of the national Public Health Emergency, States restarted eligibility renewals for more than 90 million people covered by Medicaid. This renewal volume has caused significant operational challenges for States and placed a considerable burden on Medicaid recipients seeking to renew. To tackle this challenge, USDS deployed a rapid response team to provide direct technical assistance to States to understand and identify opportunities to streamline and simplify State workload and customer experience. Through this work, the Center for Medicaid & CHIP Services (CMCS), USDS, and State partners identified an error in State eligibility systems that resulted in erroneous coverage losses for over 500,000 children and families^[1]. Thanks to the hard work, all 500,000+ people will have their Medicaid coverage reinstated across nearly 30 States. Beyond the resolution of this error, the rapid response team’s efforts on the ground in States have enabled millions of people to be renewed for Medicaid, as required by law, using existing data (ex parte), significantly reducing the burden on individuals and preventing administrative churn^[2], in particular for children. Rapid response teams have also implemented customer experience improvements with State partners, from improving renewal websites to redesigning the envelopes that package mailed notices. 

^[1] https://www.medicaid.gov/sites/default/files/2023-08/state-ltr-ensuring-renewal-compliance.pdf

^[2] Administrative churn occurs when an individual is disenrolled, likely due to the administrative burden of renewal processes, and then re-applies within a short period. Medicaid churning and continuity of care [ASPE, 2021]

This project aimed to help states identify and implement best practices in benefits delivery by clarifying Federal policies and requirements, providing easy access to tools and resources, and fostering peer learning opportunities. The project convened state benefits leaders and staff from 30 states monthly on topical workgroups and at two annual summits to learn from each other and from experts, as well as collect and share best practices, including in areas such as call centers, plain language, text messaging, data sharing, automation, and performance management. The team also clarified policies on state government texting for public benefits, coordinated the development of a joint HHS/USDA framework on the use of AI in public benefits delivery, published an updated guide on digital services vendor management, and provided direct technical assistance to multiple states on procurement.

See the 2024 project evaluation plan to learn about the project measures and methods.

In 2023, the Supporting States (“Accelerator”) team collaborated with the Aspen Institute Financial Resilience Program to convene six monthly workgroups focused on remediating delivery barriers States face: data-sharing, operations, policy and requirements, procurement, talent, and text messaging and notifications. Twenty States have attended regular meetings, including Federal staff, stakeholders, and independent experts. States are identifying specific challenges, sharing insights, and beginning to develop valuable resources. The Accelerator team also organized a training led by agency colleagues at the Federal Communication Commission to clarify permissible uses of text messaging to communicate with benefits program participants. The team is developing data sharing and reuse guidance to facilitate State use of Federal and third-party data for verifications. The team is exploring State solutions to address talent needs and better incorporate human-centered design and collection of feedback on lived experiences into program operations. The team is developing other supports for State operations in text messaging, plain language notices, call centers, and account access. The team also conducted research with States and experts to identify and prioritize leading procurement practices for benefits programs for potential Federal pilots to come.