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Maximizing Enrollment: Transforming State Health Coverage was a $15 million national program of the Robert Wood Johnson Foundation (RWJF).  It was planned in 2008 and concluded in January 2014. The program aimed to help states transform their eligibility and enrollment systems to improve enrollment and retention of those eligible for Medicaid and the Children’s Health Insurance Program (CHIP). Initiated before enactment of CHIP reauthorization in 2009 and before the Affordable Care Act in 2010, the program leveraged opportunities in these federal laws to advance the purposes of the program.  Maximizing Enrollment focused on improving state health coverage programs’ systems, policies and procedures, as well as measuring the impact of these changes.  The program aimed to increase the efficiency and effectiveness of Medicaid and CHIP in enrolling and retaining those eligible, and to establish and promote best practices in all states.


In February 2009, after a competitive grant application process, eight states were awarded up to $1 million each over four years. The eight participating states were Alabama, Illinois, Louisiana, Massachusetts, New York, Utah, Virginia, and Wisconsin. Under the direction of the National Academy for State Health Policy (NASHP), the national program office (NPO) for Maximizing Enrollment, the initial phase of the program focused on an in-depth assessment of the strengths and weaknesses in the participating states’ Medicaid and CHIP enrollment and retention systems, policies and procedures. In addition to tailored technical assistance provided to the states to develop and implement improvement plans, the program offered peer-to-peer learning opportunities to share information about challenges and effective strategies. Throughout the program the participating states received support to implement strategies focused on:


  • Simplifying processes and reducing paperwork
  • Using new technology to achieve more efficient and consumer friendly enrollment systems
  • Using data more effectively to guide and evaluate improvements
  • Changing the culture and improving coordination among agencies


Lessons learned from the program were shared nationwide over the course of the program so that other states and stakeholders could benefit from the Maximizing Enrollment states’ experiences.  Among other resources, the program’s resources include a toolkit for states to assess their own enrollment and renewal systems’ strengths and weaknesses.  Program resources also include reports, webinars, and other resources to aid states in efforts in this area, with a series of final reports and briefings in 2013-2014 concluding the work.