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At the beginning of the Maximizing Enrollment program, states participated in a diagnostic assessment, which identified the strengths and weaknesses of their Medicaid and CHIP enrollment and retention systems.  The intent was to help the participating states understand what they were doing well and identify areas that needed improvement.  The diagnostic assessment protocol (DAP) examined participating states’ systems, policies and procedures to enroll and retain eligible children by collecting available enrollment data, detailing processes and interviewing state officials and various stakeholders.  The protocol was developed and applied by Health Management Associates under the direction of the National Academy for State Health Policy (NASHP).  The assessment provided each participating state and NASHP with a basis for developing state-specific strategies, work plans and benchmarks for improvement in later phases of the Maximizing Enrollment program.   

Based on this experience, Maximizing Enrollment produced a standardized self-assessment toolkit for all states to use to assess their own strengths and weaknesses and consider options for improvement.