Introducing Our User Experience Guide for Medicaid Work Requirements
Releasing the third resource in our HR1 implementation series
Over the past few weeks, we’ve published resources focused on the back-end of work requirements implementation: a Data Source Integration Strategy Guide to help states prioritize which data connections are must-dos before 2027, and a CBV Buying Guide to help states procure consent-based income verification quickly and well. Today, we’re turning to something that doesn’t get enough attention in these conversations: the member-facing side of implementation, and why user experience is just as important as anything happening on the back end.
Here’s the number that motivates this guide: when Arkansas and New Hampshire previously implemented Medicaid work requirements, 72-82% of members who had to complete a manual renewal lost coverage - not because they were ineligible, but because they couldn’t make it through the process renewal after renewal. Current projections suggest that up to 39% of Medicaid expansion members will lose coverage when work requirements take effect nationally, even though only 13% will actually fail to meet the requirements. That gap - more than a quarter of all expansion members - is largely procedural. And a meaningful share of it comes down to whether states have built online systems that people can actually use.
No amount of back-end automation eliminates the need for good member-facing tools. Informal caregivers, self-employed workers, people with recent changes in circumstances, people who need to upload documents or reset a password or understand what’s being asked of them - these members will have to navigate state portals, apps, and call centers. When those systems fail them, eligible people lose coverage.
Our User Experience Guide for Work Requirements is built to help states take stock of where they stand and act on it before 2027. It identifies seven UX elements that drive the most member and caseworker burden: mobile access, document upload, account access, status updates, notices, multi-modal outreach, and customer support. And it describes what good performance looks like across four maturity levels for each. It also includes a maturity self-evaluation tool states can use to identify which areas most urgently need attention, and guidance on how to prioritize next steps given where they are today.
We also hope this guide can be helpful for other benefits and steady state operations; these user experience principles are larger than Medicaid or the work requirements challenge. The UX maturity model we designed can be used by a variety of public benefits programs to understand how well their current operations are performing against best practices, measure progress over time, and compare across programs and states.
Without further ado, here’s the guide:
User Experience Guide for Work Requirements
As always, if you’d like to discuss any of this in more detail, please reach out to Zack at zack@group17a.com.