The US government delivers more than 80 services that together lift almost 50 million Americans above the poverty line each year. But tens of millions of people are still falling through the cracks—going without the benefits they are eligible for because of frequent technology problems, complicated enrollment requirements, and communication failures.

For the past two years, we have been redesigning access to food assistance through Now, Code for America, the Centers for Medicare & Medicaid Services (CMS), the Center on Budget and Policy Priorities, and Nava PBC have formed the Integrated Benefits Initiative to build new human-centered approaches to improve enrollment and eligibility for people who apply for multiple programs. Read Nava’s announcement of the initiative here.

To improve enrollment and eligibility processes, we need to think about how the benefits applicant, our user, experiences our systems. Working with Code for America, we’ve started using design principles to observe, to collect data, and to learn from those results. These practices have helped us start transforming how we serve our lowest-income, most vulnerable residents: people who need health insurance or food stamps just to get by.

— Andrey Ostrovsky, MD Chief Medical Officer, Center for Medicaid and CHIP Services

Human Centered Benefits = Integrated Benefits

Millions of people qualify for more than one public benefit or service, yet the paths to enrolling are fragmented and complex. In 2013, 26.9 million children—over a third of all children in the country—were eligible for both Medicaid and SNAP. For millions of others, life changing events and health conditions make them eligible for specific services in addition to basic assistance.

People applying for more than one benefit are required to duplicate the same information across different forms because of fragmented government operation. Designing the service around the applicant’s needs will simplify processes, reduce paperwork and ultimately aim to deliver the service faster and more effectively.

Extra R&D Capacity for State Agencies

State leaders want to move forward, but often feel like their hands are tied by legacy systems, complex requirements, or shifting eligibility criteria; and they don’t have the resources to get ahead of their escalating costs. Our goal is to design and build the ideal enrollment service from the applicant perspective but also working directly with states to understand their needs, to build tools and services that help modernize the legacy systems and better serve residents.

Elevating Frontline Workers

Technology can help achieve the Integrated Benefits Initiative goals, but ultimately all government services have a human face: the tens of thousands of frontline caseworkers that cope with outdated tools and difficult to use systems as they serve their communities. We’re doing research in field offices around the country to better understand the realities of delivering these critical services, and the challenges and opportunities that exist to improve the caseworker experience along with the applicants.

Changing Policies and Operations

Benefits enrollment and eligibility is a complex web of federal, state and local policy and service delivery. Technology at scale makes visible operational excellence and failure across the many levels of government agencies, vendors, and community-based providers. Our goal is elevate effective policy changes, model efficiencies and measure cost savings as we build and deliver the ideal integrated benefits service with our pilot states.

Our Approach

We’re improving the entire process of accessing benefits in states across the country. Here’s how:

  • Strategic field research. We are offering states pro-bono strategic field research to help agency leaders dig deep into the programs they manage, uncover new opportunities, surface the challenges that caseworkers face, and identify the evidence-based paths toward truly integrated benefits delivery.

  • 3-5 Select Pilots. Based on the findings of field research, we will rapidly prototype open-source tools in partnership with state agencies. Each prototype will seek to catalyze a more human-centered design of benefit systems.

  • Special Convenings. To share our open source software and the insights our work generates, we will convene leaders across local, state and federal government to build connections and leverage what works.

How we work

  • Build from the ground up. We work on location, in the context of real services being delivered to Americans. Local needs and priorities inform what gets prototyped, not nationwide guidance.
  • Work with clients and case workers. We work by directly serving clients, shadowing caseworkers, and considering organizational constraints.
  • Build in the open, share as we go. Our open source software is paired with published documentation, and regular contact with interested state leaders and vendors alike.

  • Bring everyone to the table. We convene all levels of government and broader stakeholders as we build so that learning together also creates momentum for overcoming policy and operational barriers together.

Our Goal

  • Design the ideal integrated enrollment service, demonstrating that government can deliver better outcomes for clients, better tools for caseworkers, with less complexity and less risk for leaders.


Try our first prototype