Idaho Department of Health and Welfare

Bringing affordable care to the citizens of Idaho

THE CHALLENGE

The State of Idaho needed to launch their own healthcare exchange in time for the second open enrollment period of the Affordable Care Act (ACA). Recognizing that enrollment and renewal needed to happen online, and that many applicants would have only basic computer literacy, Idaho’s Department of Health & Welfare (IDHW) wanted to develop a self-service portal with a strong focus on personable customer experience.

THE SOLUTION

A robust digital platform was created for eligibility evaluation and beneﬁts management that was both dynamic and intuitive as well as being ADA compliant. The site handled almost 10,000 unique visitors during the ﬁrst ﬁve days of open enrollment and the design was nominated for a Webby Award.

Idalink interstitial and sample form page

Identifying core scenarios

The primary purpose of the idalink portal is to facilitate applications for Health Coverage Assistance (HCA). In order to determine beneﬁts eligibility status, applicants are required to provide a signiﬁcant amount of personal and ﬁnancial data. Working with subject matter experts and spending days observing representatives at the call center provided the foundational knowledge needed to design the system. Five key scenarios were identified at the start that were representative of the range of interactions customers can have, depending on whether or not they are known to the system and whether they have an existing account.

When one size does not fit all

Built-in logic was integrated to dynamically reﬂect the experience someone might have if they called in to complete this form over the phone or with a live person. Breaking the long form into discrete sections with informational overviews ensured a more optimal user experience. A consistent global utility bar and expansive left navigation provided a very ﬂexible and modular design, supporting IDHW’s goals to streamline and modernize their solution.

The Beneﬁts Summary enabled returning customers to view their beneﬁt programs, apply for new beneﬁts, view messages and manage their account. The business rules behind these eligibility determinations were extremely complex, and in designing this screen, every foreseeable use case had to be accommodated.

A robust and modular solution

Medicaid eligibility is impacted by a range of criteria, including age, income and disability status. This meant that certain responses triggered the form (and navigation) to build dynamically to ensure all relevant data was captured from the applicant.

Income was particularly challenging in terms of requirements deﬁnition and design, given the range of income types that exist and associated tax implications, all of which impact HCA eligibility. The ﬁnal solution included robust in-line editing, calculations and logic to prevent errors.

Design documentation and extension

The business rules and design system were documented in an extensive design specification to ensure a smooth hand-off and to assist with customer support. Core scenarios, global components, individual templates and screen elements were all deﬁned to ensure a consistent extension of the original framework in future.