Assessing the value of Medicaid prescreening in a county public health unit

The purpose of this study was to determine if already-existing staff in a rural health department could effectively increase access of their clients to Medicaid. All "sliding fee" patients seeking services were asked a series of questions to determine their categorical eligibility for Medicaid. Those identified as potentially eligible were formally referred for complete financial eligibility determination, and outcomes of those referrals were examined to determine the number of patients newly insured. The study revealed that the majority of poor clients being served in the health department were categorically ineligible for Medicaid and that the majority of potentially eligible patients declined to complete the application process. The process cost the health department twice as much in staff time as it could possibly have recouped in Medicaid reimbursements.