Don’t Let FSSA’s Computer Algorithm Kick Hoosiers off Medicaid

FSSA is replacing non-profit CICOA with Maximus, Inc. ($5B corp) to use the interRAI software algorithm for Medicaid eligibility screenings. This system will kick Hoosiers off Medicaid. interRAI is deeply flawed. As an "off-the-shelf" tool, it embeds systemic discrimination, ignores individual needs, and lacks public input. States use arbitrary subsets of its questions (e.g., D.C. excludes cognition, and Missouri's varied choices are effectively hidden regulatory decisions). This creates an illusion of objectivity while undermining genuine care. Consequences in other states are dire. In Arkansas, an algorithmic assessment led to disastrous care allocations, failing to consider conditions like cerebral palsy and forcing individuals toward institutional care. In Missouri, proactive transparency revealed 66% of current beneficiaries would lose eligibility, forcing a crucial pause in implementation. Indiana risks similar devastation without public oversight. Beyond eligibility, interRAI has inadequate evidence of positive health outcomes. Its care plans often don't guide daily care, as frontline staff (80-90% of direct care) find it irrelevant due to time constraints, insufficient equipment, information overload, and complex terminology, leading to low compliance. It's seen as an administrative burden, not a clinical guide, and is not customizable to Indiana's unique programmatic needs. Demand that FSSA act responsibly for Hoosiers. Immediately halt the interRAI algorithm for Medicaid eligibility. Develop a state-specific Universal Assessment Tool (UAT): A customized, person-centered tool to streamline eligibility and assessments across programs, tailored to individual needs. Ensure proactive public testing and transparency; all algorithmic design choices affecting eligibility must be treated as regulatory changes, subject to public notice and comment. Prioritize user-friendly clinical summaries and training. Equip staff to understand and utilize data effectively, fostering peer support. Integrate multidimensional complexity assessments. Use tools like COMID to assess factors like informal caregiver burden. Leverage advanced analytics. Use data-driven systems for optimal capacity and workforce planning, ensuring efficient care delivery. Don't let an algorithm deny essential care. Demand FSSA learn from other jurisdictions and empower Hoosiers and their care providers.