ABSTRACT
This chapter discusses the key administrative tasks and offers suggestions for efficiency. It focuses on a Medicaid-plus-tax-credits initiative, for expanding health insurance coverage also involve new administrative roles for federal and state governments, employers, health plans, and individuals. The planners of these initiatives will need to consider use or redesign of tax administration, payroll deductions, state Medicaid and State Children's Health Insurance Program (SCHIP) application and enrollment processes, consumer choice, and other administrative issues. Application and enrollment are the first steps in the administrative process, and they are critical to the success of a coverage initiative. The second major step for an administrative system will be to assure timely and accurate payment of premiums and to coordinate premium payment shares from individuals, federal tax credits, state assistance, and perhaps employers. Administrative systems for a Medicaid-plus-tax-credits initiative would be called on to facilitate consumer choice among competing health plans. Choices about administrative systems have implications for costs and performance.
