1 / 30

Determining Disability

This article explores how states can ensure that all recipients who are unable to work are exempted from Medicaid work requirements. It discusses disability determination processes, consequences of Medicaid loss, data matches for disability determinations and applications, and the effectiveness of work requirements.

lindawhite
Download Presentation

Determining Disability

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Determining Disability Medicaid Work Requirements and the Limits of Digital Health Rachel Gershon October 16, 2018

  2. 4,353

  3. Medicaid work requirement status Pending Approved Invalidated by a court Based on Kaiser Family Foundation, State Health Facts, Approved Section 1115 Medicaid Waivers and Pending Section 1115 Medicaid Waivers, September 28, 2018

  4. How can states ensure that they are exempting all recipients who are unable to work?

  5. Disability and work Determined Disabled Not Able to Work; Not determined disabled Able to Work

  6. Example 1: Quick determination Determined Disabled Not Able to Work; Not determined disabled Able to Work

  7. Example 2: Slow determination Not Able to Work; Not determined disabled Determined Disabled Able to Work

  8. Example 3: Retains ability to work Not Able to Work; Not determined disabled Determined Disabled Able to Work

  9. Example 4: In and out of ability to work Not Able to Work; Not determined disabled Determined Disabled Able to Work

  10. Example 5: Not able to work Not Able to Work; Not determined disabled Determined Disabled Able to Work

  11. Disabilityand work Not Able to Work; Not determined disabled Determined Disabled Able to Work

  12. Data Matches for disability determinations • Social Security Administration • Veteran’s Affairs • SNAP • Other federal and state agency determinations

  13. Data match for disability determinations Not Able to Work; Not determined disabled Determined Disabled Able to Work

  14. Consequences of Medicaid loss • Access to health care • Financial protection • Access to employment • Access to disability determinations • Access to medical professional • Substantial gainful activity

  15. Example 2: slow determination Not Able to Work; Not determined disabled Determined Disabled Able to Work

  16. Access to medical professional Not Able to Work; Not determined disabled Determined Disabled Able to Work

  17. Substantial gainful activity Not Able to Work; Not determined disabled Determined Disabled Able to Work

  18. Data Matches for disability applications

  19. Data match for disability applications Not Able to Work; Not determined disabled Determined Disabled Able to Work

  20. Who is not applying for SSA benefits? • Including disability income applicants mitigates the substantial gainful activity issue, but leaves other populations out. • Not yet gathered the information to apply • Does not meet SSA disability standards

  21. Consequences of Medicaid loss Not Able to Work; Not determined disabled Determined Disabled Able to Work

  22. Claims analytics • Diagnoses • Medical expenditures • Social determinants of health

  23. Claim analytics Not Able to Work; Not determined disabled Determined Disabled Able to Work

  24. Consequences of Medicaid loss • Medicaid as a work support • “A large majority of employed Group VIII enrollees (83.5%) reported that Medicaid made it easier to work; most unemployed enrollees (60.0%) reported that Medicaid made it easier to look for work.” • “[Medicaid] allows me to get surgery which has allowed me to return to work.” -Ohio Group VIII evaluation

  25. Consequences of Medicaid loss Determined Disabled Not Able to Work; Not determined disabled Able to Work

  26. Example 5: Not able to work Not Able to Work; Not determined disabled Determined Disabled Able to Work

  27. Going analog • Self-report • Process for analyzing self-report • Who bears the burden of uncertainty?

  28. Are work requirements worth it? • Needle in a haystack • Medicaid as a work support • Potential for disrupting disability determination process

  29. Discussion • Standards for determining disability • Processes for determining disability • Role of technology • Effectiveness of work requirements

  30. Thank you!

More Related