A A A

Home >  Qualifications >  Project Portfolio >  Benefit Recovery ...

Benefit Recovery Assessment

141
Process
Business Process Management
Government
Benefit Recovery
Improving Performance in SNAP, TANF, and Medicaid Benefit Recovery Processes

The State of Florida’s Benefit Recovery Unit (Office of Public Benefits Integrity (PBI), Department of Children and Families) was facing a growing backlog of Benefit Recovery referrals. The associated uncollected claims were valued at more than $14 million.

  • Referral backlog grew to 43,640 unworked claims, representing roughly one year's worth of work for the Unit. The backlog grew by 58% between 2011 and 2012.
  • BR’s current staffing levels were inadequate to meet the current level of work and additional headcount reductions of 24% were anticipated.

The Benefit Recovery Unit’s (BRU) executive team needed help with operating more efficiently and effectively. They decided to conduct a detailed analysis of the internal process and practices and to develop improvement recommendations.

Iknow was selected by the State’s Benefit Recovery Unit to assess their core business processes, performance goals and measures, policies and procedures, organizational structure, and opportunities for outsourcing.

The project activities included:

  • Seventy in-person individual and group interviews conducted with:

Florida Benefits Recovery Unit, Division of Public Assistance Fraud (DPAF), and the state’s Attorney General’s office;

HHS personnel in five states for benchmarking and best practices collection: Texas, Georgia, Mississippi, Connecticut, and Pennsylvania; and

USDA Food & Nutrition Service (FNS) and Centers for Medicare & Medicaid Services (CMS) program representatives.

  • Nearly 2 million data records, covering six years of transactions and financial information, extracted from the Integrated Benefit Recovery System (IBRS) and analyzed. Analyses covered SNAP, TANF, and Medicaid.

The project team created the following deliverables:

  • Findings Report (200+ pages)
  • Recommendations Report (60+ pages)
  • Leadership Action Items with Benefit Case (spreadsheet).

The team identified over 60 specific improvement opportunities; recommendations were grouped into four improvement areas:

  • Improved collection activity
  • Enhanced claiming
  • Backlog reduction
  • Cost avoidance.

Some of the specific next steps were:

  • Launch a series of process improvement teams—to free-up enough capacity to withstand the pending reductions in staff—and set a target of doubling performance within 24 months
  • Establish current-state (baseline) performance metrics
  • Start a series of mini-IT projects to implement key workarounds—especially prioritizing and managing late payments
  • Reorganize the Benefit Recovery Unit
  • Initiate the re-procurement of a vendor to perform enhanced collections
  • Launch efforts to build regulatory and legislative support.