Connecting Medicaid Beneficiaries with Providers

Director of Client Engagement

March 20, 2018

Like many states, Idaho has been working to expand Medicaid coverage, but has run into legislative resistance. For citizens that do have coverage, challenges still remain to receiving care, not least in identifying and getting accepted by a Primary Care Provider (PCP).

We thought this was a good time to highlight the digital initiatives Idaho is making to help these citizens gain better access to providers, through the Live Better Idaho (LBI) platform – a public-private collaboration aimed at making support services easier to discover.

What’s Live Better Idaho?

Powered by CiviServ, a SaaS (software as a service) platform, livebetteridaho.org helps Idahoans seek, find, and access services across a range of public, non-profit, faith-based and private organizations. These services encompass a broad variety of needs such as help with healthcare, food and nutrition, employment, education, childcare, and family and veterans services.

The goal is to match visitors with potentially helpful services based on some very basic personal data. Citizens can anonymously enter age, family size, and income to filter for available services, and find out if they are eligible based on household circumstances. They can also create an account to save favorite contacts for future, subscribe to receive updates, and save pertinent events and dates to a calendar.

Connecting Medicaid patients with PCPs

Frequently low-income individuals and families are matched with Medicaid as an eligible program, and can be directed to the process for eligibility confirmation and enrollment. However, even once enrolled, Medicaid beneficiaries frequently face a challenge in finding a Primary Care Provider (PCP) that accepts Medicaid. To address this, Live Better Idaho recently added a feature that makes it easy for Medicaid beneficiaries to search for Medicaid friendly clinics in their area and request access.

Eligible Medicaid participants can enter their city or zip code to access a list of potential clinics and providers. They can then submit a request for a particular clinic. In partnership with Healthy Connections, the request is processed, and if approved, a confirmation letter will be mailed to the participant with details on the available clinic.

Enrollment in Healthy Connections is through the clinic, not a specific provider. The clinic works with each person to determine the best PCP or primary care team.

Upcoming enhancements will include more detailed search results with maps that show the locations of the clinics listed in the search.

Benefits of service discovery tools

Connecting Medicaid beneficiaries with PCPs is just a small part of the broad challenge that the LBI platform seeks to address. In our article on Targeting Social Determinants of Health about “Why Idaho’s online service discovery tool can improve health” we detailed the ways in which LBI strives to address all aspects that effect health.

Social determinants of health include daily needs like housing and food as well as education and job training, transportation and social support services. Research into the influence of these social determinants indicates that health is in fact about far more than doctor visits.

As a result, the LBI platform serves to provide a broad array of resources aimed at improving living and work circumstances, which in turn can improve health, and decrease visits to medical providers. Ultimately, this can decrease the overall cost/tax burden of programs like Medicaid.

Self-referral also helps citizens feel more empowered around accessing services, which can ease discomfort around receiving aid, and make the difference between someone staying in crisis or getting to recovery.