Ohio Department of Medicaid Eligibility Data Hub Case Study

This case study details the collaboration between the Ohio Department of Medicaid (ODM) and Public Consulting Group (PCG) to enhance the efficiency of the Health and Human Services (HHS) Eligibility Data Hub. The project aimed to address the challenges posed by a significant increase in Medicaid enrollment and staffing shortages following the COVID-19 pandemic. The case study outlines the necessity for automating eligibility and enrollment processes to manage the increased workload effectively. It describes how PCG implemented a stand-alone eligibility data hub that connects to multiple data sources through a single interface, thereby streamlining the verification of application information and improving eligibility determinations. The study highlights the specific solutions provided, including automated policy-based analytics and the integration of various state systems. The results indicate substantial improvements in the efficiency of eligibility redeterminations and a reduction in error rates, showcasing the effectiveness of the implemented solutions.