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Slowing Medi-Cal Churn: Counties Collaborate to Improve Efficiency

Vicki C. Grant and Laura Heller, Southern Institute on Children and Families

Thirteen county Medi-Cal eligibility offices collaborated to improve enrollment and retention of eligible children. During an intense 14-month initiative, the eligibility workers gathered data, tested ways to improve processes, and measured results.

Almost one million California children were uninsured for some or all of 2002, despite being eligible for coverage under Medi-Cal or Healthy Families (SCHIP). Many of these were dropped from coverage and then re-enrolled within two months in a phenomenon known as "churning." Besides being extremely expensive for the state, churning entails serious health and financial consequences for the children and families affected.

This 2008 report describes an initiative in which 13 counties collaborated to improve the Medi-Cal eligibility determination process and to maximize the enrollment and retention of eligible children. Funded by a 2006 CHCF grant to the Southern Institute on Children and Families, the Medi-Cal Eligibility Process Improvement Collaborative (MEPIC) focused on systematic data collection, testing multiple ways to improve the eligibility processes, and measuring results. The collaborative process fostered continuous idea sharing and improvement for the participating county offices.

The strategies that were tested and adopted are described in the report, as are recommendations for continuing to move forward. The complete report is available under Document Downloads.