Integration of Medicaid Enrollment in Health and Other Services through Staff Education

Objective: To increase the number of Medicaid enrollments among eligible, uninsured American Indians/Alaskan Natives; to provide Medicaid education at the community, individual, and family level to increase understanding of eligibility requirements and Medicaid benefits; to integrate Medicaid enrollment and education in health and other services by training and educating all care providers, including support staff, of the importance of Medicaid enrollment and identify eligible patients

Description: First Nations Community Healthsource (FNCH) has been able to increase Medicaid enrollment and education through the integration of these activities into health and other services by training and educating all care providers, including support staff, of the importance of Medicaid identification and enrollment. The clinic has found that it is important that everyone be educated about the importance of Medicaid enrollment to serve as critical referral sources who can provide a warm hand off to Medicaid enrollment specialists while the patient is in the clinic. This minimizes attrition, loss to follow up, and maximizes actual enrollments. Medicaid enrollment must be a collaborative approach with all providers involved in the patient’s care committed to make the initial referral step to begin the enrollment process. The medical and front desk staff is educated and some of the front desk is trained to provide actual Medicaid enrollment at the front end. There also are Medicaid enrollment specialists who can see patients and complete enrollment at the clinic, as well as in the community. The Medicaid enrollment specialist is responsible for doing the actual enrollments, working with providers, and following up with referrals. Medicaid enrollment requirements are articulated to patients at the time of their appointment confirmation to ensure patients bring in the required documents needed for Medicaid enrollment. This again minimizes attrition and application denials due to the lack of required documents.

Results/Accomplishments/Evidence: Through this initiative a majority of uninsured patients have had a Medicaid enrollment screening and application submitted. In 2011, enrollment of more than 700 children and families in Medicaid occurred. Data is collected on the number of enrollments, status of applications (e.g., denials versus approvals), demographic information on enrollees, and outreach and enrollment activities (including number of brochures distributed). The results showed that over the past three years, 1,515 Medicaid applications were completed and there were more than 500 Medicaid/CHIP renewals. The age group most impacted was ages 0-10 years.

Population of focus: American Indian or Alaska Native, Children, Adolescents, Adults, Limited English Proficient, Women

Setting: Community health center, Emergency room/clinic, Primary care facility

Level of intervention: Individual, Family, Community

Resources/Qualifications Needed: The cost of activities vary, however on average of $20 per client covers the time spent by providers and the Medicaid enrollment specialist. Previously, CHIPRA funding was used to cover cost, however private foundation funding is currently used.


Linda Son Stone
Executive Director
First Nations Community Healthsource
5608 Zuni SE, Albuquerque, NM 87108