Policy & Practice | Fall 2025

or complex casework. Without fun damental process redesign, agencies risk a cycle of attrition and inefficiency that no amount of new hiring or salary increases can resolve. Business process transformation—streamlining workflows, leveraging automation, and modernizing technology—is essential to alleviate workforce strain and ensure sustainable, high-quality service delivery. States are scrambling to recruit and retain workers, with at least 20 states enacting legislation to address public workforce challenges in 2024. 6 But higher pay alone won’t fix broken pro cesses or outdated systems. What Works: Lessons from State-Based Health Insurance Exchanges Contrast this with the experience of state-based exchanges, which have embraced modern technology and human-centered design. During the 2025 open enrollment, GetInsured’s Consumer Assistance Centers handled more than 796,000 calls for Georgia, Nevada, Pennsylvania, and Virginia state-based exchanges—a 32 percent increase from the prior year. Average wait times were less than 11 seconds, and customer satisfaction stayed at a remarkable 94 percent. How? By automating routine tasks, offering robust self-service options, and deploying virtual agents to handle basic inquiries. For example, in the 2024 open enrollment period, nearly 15 percent of calls were resolved entirely by a virtual agent, and another 10 percent were seamlessly trans ferred to brokers or Medicaid teams as needed. This freed front-line workers to focus on complex cases, while con sumers got quick, accurate help. Plan selection provides another great example. With human-centered design, GetInsured created a user friendly, e-commerce-style “tile” plan display page that helps consumers compare health plans easily. This change led to a 25 percent increase in engagement and a 15 percent drop in abandonment rates. The right tech nology, designed around the user, made all the difference.

to customer-centric, data-driven pro cesses that build public trust. With these changes, caseworkers can focus on the most challenging and mean ingful work. Workers will be more satisfied, and the people they serve will get timely, respectful service. A Call to Action State human services workers are dedicated, compassionate, and skilled. They deserve tools and systems that match their commitment. The families and individuals they serve deserve timely, accurate, and dignified support. It’s time for states to invest in the technology and human-centered design that is proven to work. With modern systems and innovative processes, we can restore public faith in state govern ment—one successful case at a time. Vimo is pioneering the redesign of Medicaid eligibility and enroll ment. With our new Medicaid Express solution, states can increase opera tional efficiency, streamline data management, reinforce program integrity, and most important, support a satisfied workforce and thriving client population. Combining this with our deeply skilled business process redesign (BPR) practice can take it to the next level. BPR works hand-in-hand with Medicaid Express to ensure that technology and process transformation go together—delivering sustainable results for agencies and the communi ties they serve. Let’s give our human services workers, and the people they serve, the future they deserve. Reference Notes 1. https://www.medicaid.gov/resources-for states/downloads/eligib-oper-and-enrol snap-january2025.pdf 2. https://www.cms.gov/newsroom/ fact-sheets/fiscal-year-2024-improper payments-fact-sheet 3. https://www.hawaiipublicradio.org/local news/2025-03-31/snap-program-facing staff-shortages-in-hawaii 4. https://www.denverpost.com/2023/08/17/ colorado-state-job-vacancy-hiring-openings 5. https://medicaiddirectors.org/resource/ medicaid-agency-workforce-challenges and-unwinding 6. https://www.ncsl.org/health/state actions-to-bolster-the-public-health workforce

Human Services Deserve the Same

Families in crisis face unique chal lenges, but that doesn’t make the lessons from state-based exchanges any less relevant: n Full automation with a logic-driven verification hierarchy reduces manual errors and speeds up eligi bility decisions. n Simple, intuitive digital processes make it easy for people to enter infor mation and submit documentation. n Self-service tools and virtual agents ensure help is available when people need it 24/7, cutting down call center traffic and wait times. n Dedicated portals for applica tion assisters allow community organizations to assist families in real-time with system navigation and document uploads. With modern, intelligent systems, eligibility workers could spend less time on data entry and more time helping families with the greatest needs. Workers would be empowered to solve real problems, not just shuffle paperwork. The Path Forward: From Data Repositories to Capacity Creators Imagine a future where eligibility systems do more than store data—they generate capacity. n Automation eliminates repetitive manual tasks. n Robotic process automation verifies information, compiles clear, audit able documentation, and reduces payment errors. n Virtual agents and modern user interfaces make processes accessible, even for those with limited digital skills. n Data analytics direct resources to where they are most needed and drive process improvements that create the greatest value. n Community partners are integrated, so families get help where and when they need it.

This isn’t just about moderniza tion—it’s about fundamentally shifting

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