WA: HCA, VA Partner to Help Veterans Avoid High Medicaid Costs

It is commonly acknowledged that low-income veterans and their families find themselves on Medicaid, even though, in many cases, they would be eligible for more generous benefits from the Department of Veteran Affairs. However, many veterans who are entitled to these programs end up on Medicaid – which does not necessarily help with their specific difficulties and has significant implications for their family members.

PARIS, the Public Assistance Reporting Information System, has had much success in recent years identifying veterans that are eligible for monetary and medical benefits through the VA, which has reduced their total reliance on Medicaid. This program began in Washington in 2003 to identify those veterans who are slipping through the cracks and not receiving adequate benefits. With this success, the program has become a model in 31 other states.

Since 2003, the Washington State Health Care Authority and the Washington State Department of Veterans Affairs have partnered up to make sure that those eligible are getting the benefits that can be afforded to them through the federal VA budget. A 2011 report released by this project announced that:

“In response, the veterans are getting better benefits, and the cost is picked up by the state. Even better—while Medicaid must try to recover costs from client estates, which may require selling a family home—federal veterans programs have no strings attached. Veterans earn their federal benefit with their military service.”

Bill Allman, with the Washington HCA and architect of the program, had been aware that poor veterans and their families were enrolled in Medicaid, but never realized “that they might also be eligible for richer federal benefits.” The PARIS system was exactly what he was looking for.

The PARIS data is synced to an individual’s social security number, and has information about state welfare and medical assistance billings and their eligibility for civil service benefits included. Armed with the databank, Allman was able to uncover who was eligible for more robust benefits but was not receiving them. He continues that being on Medicaid:

“Was a disadvantage in another way. When veterans died on Medicaid, their families usually lost their small estates because long-term-care-related Medicaid clients usually pay for a small portion of the health care they receive, but the programs do require the recovery of those costs if a client dies and leaves any kind of estate behind.”

This does not apply for veterans receiving federal benefits, as the benefits paid out to veterans and their families are provided in gratitude for their service to country.

Allman used the federal databank to locate veterans on Medicaid and help them then transition to federal benefits. Beginning in 2003, Allman began to focus on long-term care beneficiaries and partnered with the Washington State Department of Veterans Affairs.

The program has grown since then, and has become the model for many more states, “with more than two dozen now beginning to evaluate the PARIS system and set up similar programs.” In the past year alone, 1,257 additional Medicaid recipients have been connected through the program with over $1.5 million in cost avoidance, enabling them to access their VA benefits. Combining all the recipients of the program, by implementing this system contributed to a total of over $5 million in total cost avoidance so far in FY13.

This also had benefits at the state level too, by lightening the load on the state Medicaid budget and transferring it to the federal VA budget. Beyond saving millions of dollars for those veterans, the Washington taxpayers have benefitted by avoiding $30 million in excess Medicaid spending.

This program is now set in place to help veterans returning from Iraq and Afghanistan and future veterans.