Benefit administration: some lessons from the United States

The UK may have some claim to distinction in its efforts to transform the benefits system, but we are not alone.  In the United States, revisions to health care have been taken as a stimulus to States to introduce new computer systems that will solve all the problems, typically covering Medicaid (health care for people on low incomes), food stamps and other benefits such as help with maternity.  Kentucky was early off the blocks: they hired Deloitte Consulting to introduce a new system.  50,000 people suffered ‘massive disruption.’  The Kentucky Courier-Journal reported:

“State workers, bewildered by the complicated new Benefind system, find themselves obstructed from helping many clients by errors, glitches and programming flaws.”

When Deloitte moved on to their next big contract with Rhode Island, covering 30,000 people a month, they were determined not to repeat the same mistakes.  A spokeswoman explained to the Providence Journal in Rhode Island:

“The design, development, testing and implementation of this new system is unique to Rhode Island and the people we serve. Kentucky used a different approach on all of these things.”

Instead, they found new ones to make. The Governor of Rhode Island complained that

“We paid them a lot of money, we didn’t get what we paid for. And they represented to us that it was in much better shape than in fact it was: defective functionality, incomplete interfaces, engines that still aren’t working.”

The formal  Assessment of the Unified Health Infrastructure Project  (it’s quite short, and worth reading) reports that

  • the IT system was not functioning properly
  • despite reassurances from the contractor, the system was not ready to go live when it did
  • too much was taken on trust because of the contractor’s experience in industry
  • staff had not been properly trained
  • “Basic user functionality and important interfaces … have significant defects or have been deferred, requiring extensive manual workaround processes”
  • benefits were not processed when they should be, and not withdrawn when entitlement had ceased; there were “errors in eligibility determination, benefits issuance, and
    provider payments”.

To those engaged in Universal Credit, it all looks eerily familiar.

Nothing daunted, Deloitte is now engaged in an even bigger project, providing a new system for income testing and assessment for the state of Georgia, expected to cover three million people.  A spokeswoman for Georgia’s Department of Human Services has reassured Georgia Health News that “We had the benefit of watching other states.”   As do we.

Leave a Reply