Fraud, waste, and abuse are persistent topics of discussion in Health and Human Services (HHS) programs, which will likely become even more critical in light of the recent administration change. These issues not only strain public resources, but undermine the trust citizens place in government agencies and the services they provide. While there are many ways of addressing these problems, citizen engagement stands out as a powerful tool—one that ensures proactive communication and trust-building while reducing errors and inefficiencies. By fostering a stronger connection with citizens, HHS agencies can achieve better outcomes while safeguarding program integrity.
To explore how proactive citizen engagement can reduce fraud, waste, and abuse, let’s take a look at two real-world use cases: Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
Use Case: Medicaid – Proactively Notifying Beneficiaries of Eligibility Changes
Medicaid programs often face challenges related to outdated beneficiary information, such as changes in income, employment status, or household size. These inaccuracies can lead to fraudulent claims or wasteful spending. For example, beneficiaries may remain enrolled despite no longer meeting eligibility criteria, resulting in financial losses for state agencies.
By proactively notifying Medicaid beneficiaries about eligibility changes, agencies can ensure that recipients remain aware of their responsibilities and obligations. Automated, timely communications—whether via email, text, or phone—can alert beneficiaries to review and update their information, reducing the likelihood of fraudulent claims and ensuring appropriate allocation of funds.
Use Case: SNAP – Automating Verification Updates for Income Reporting
SNAP, which provides essential nutritional support to low-income families, also faces challenges in maintaining accurate beneficiary data. Income changes, for instance, can affect eligibility and benefit levels, yet many participants fail to report updates promptly, leading to overpayments or underpayments.
Automating verification updates through citizen engagement tools streamlines the income reporting process. By integrating real-time data checks and sending automated prompts to beneficiaries to update their income information, agencies can ensure benefits are accurately allocated. This reduces the potential for fraud and waste while maintaining the program’s integrity.
Tackling These Challenges with Inspire Evolve
Modern CCM platforms like Quadient’s Inspire Evolve offer the tools HHS agencies need to proactively engage citizens and address the issues highlighted in the Medicaid and SNAP use cases. Here’s how:
Proactive Notifications: Inspire Evolve enables agencies to create and deliver timely notifications about eligibility changes or reporting requirements via omnichannel communication. This ensures that beneficiaries receive critical updates in their preferred format, reducing misunderstandings and missed deadlines.
Real-Time Data Integration: The platform integrates real-time data from various systems, allowing agencies to automate communications based on current beneficiary information. This supports faster, more accurate updates and ensures compliance with program rules.
Workflow Automation: Inspire Evolve’s Generate Batch feature simplifies the creation and delivery of high-volume communications, such as eligibility reminders or verification requests. By automating these processes, agencies can save time and focus resources on other priorities.
Further Enhancing Citizen Engagement
In addition to addressing fraud, waste, and abuse, Inspire Evolve provides features that aim to further enhance citizen engagement across a variety of HHS programs:
AI-Powered Content Creation: The Inspire Evolve AI Assistant empowers business users to create clear, effective communications in less time. By eliminating the need for technical expertise, agencies can produce high-quality messages that resonate with beneficiaries and drive action.
In-the-Moment Interactions: Inspire Evolve supports timely, personalized digital interactions that meet citizens where they are. Whether it’s a mobile notification or a secure email, agencies can deliver the right message at the right time to encourage compliance and engagement.
Enterprise-Grade Scalability: With Generate Batch, Inspire Evolve supports high-volume communication needs, ensuring agencies can handle the scale of public benefit programs without sacrificing efficiency or accuracy.
The Path Forward
As recent administration changes bring renewed scrutiny to issues of fraud, waste, and abuse in HHS programs, the need for proactive citizen engagement has never been more critical. By investing in technologies that prioritize clear, timely, and personalized communication, agencies can not only reduce fraud and waste, but enhance the citizen experience.
The Medicaid and SNAP use cases demonstrate the tangible impact of citizen engagement. Proactively notifying beneficiaries of eligibility changes and automating verification updates reduce errors, improve compliance, and foster trust between citizens and their government.
With its robust capabilities, Quadient’s Inspire Evolve provides the tools agencies need to navigate this new era of accountability. By taking a citizen-first approach, agencies can tackle fraud, waste, and abuse while delivering better outcomes for individuals and families in need.
To learn more about how to make an impact for agencies, workers, and citizens, check out Evolve today!
