- Outside assistance and detailed investigations of errors drive better root cause analysis.
Most states lack timely, detailed data to support robust root cause analysis of payment errors. As a result, corrective action plans often address what went wrong, rather than why.
Historically, states have relied on existing policy staff and specialists to analyze error patterns. While these individuals bring deep knowledge of policy implementation, they often lack the time, resources, and data analysis expertise needed to uncover consistent trends, especially within large or complex datasets.
Investing in outside support and improved data systems can help states move beyond surface-level assessments. The Food and Nutrition Service (FNS) has noted that “Frequently, the ‘root causes’ named in CAPs were descriptions of what happened to result in an error (e.g., information withheld by client). Given these ‘root causes,’ there are many possible explanations of why the error occurred.”i
A single issue, such as withheld information, might result from confusing agency communication, language access barriers, or intentional omission. In many cases, multiple contributing factors are at play, requiring deeper investigation and more sophisticated analysis.
Without clearer insights into why errors occur, states can’t effectively reduce their payment error rates.
- Bypass existing IT or data systems for high-impact error correction.
FNS regional offices have stated bluntly that, “A lot of [persistent errors] is that States don’t have control over system fixes. … They have iron-clad contracts with their eligibility systems vendors that [don’t] enable them to make changes or improvements.”ii
Over the last decade, most states have implemented integrated eligibility systems that include multiple programs, including Medicaid, SNAP, and TANF. It often takes contractors months or years to implement changes to these systems, a reality that will only get exponentially worse as major changes to eligibility rules in the BBB Act have the potential overwhelm the few contractors who operate these systems for states around the country. The major changes are likely to drown out calls for smaller changes, even though those smaller changes will heavily impact PERs.
With hundreds of millions of dollars at stake, states need to regain control of their SNAP processes.
Where previously states may have tolerated slowness from eligibility system contractors, the stakes are now simply too high. States need to think outside the box, overlaying quick fixes on top of legacy system problems to solve high impact root causes. This may mean using robotic processing applications, or cloud-based solutions linked to the legacy eligibility system that allow for better user interfaces, additional prompts for eligibility workers, and additional notifications with better delivery processes and more clear language.
