Digital Health @ Harvard, Rachel Gershon: "Determining Disability: Medicaid Work Requirements and the Limits of Digital Health"

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Information about Digital Health @ Harvard, Rachel Gershon: "Determining Disability:...

Published on October 30, 2018

Author: petrieflom

Source: slideshare.net

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

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

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

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

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

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

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

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

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

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 Able to Work Not Able to Work; Not determined disabled Determined Disabled

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 Able to Work Not Able to Work; Not determined disabled Determined Disabled

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

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

18. Data Matches for disability applications

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

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 Able to Work Not Able to Work; Not determined disabled Determined Disabled

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

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

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 Able to Work Not Able to Work; Not determined disabled Determined Disabled

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

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!

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