While the mandate appears straightforward on paper, its practical implementation presents a monumental administrative challenge. Millions of people will need to submit documentation every month, exemption requests will require careful review, and agencies must be prepared for CMS audits at any time.
For deputy Medicaid directors, operations managers, and program leaders, the central question is unavoidable: How can this unprecedented workload be managed without overwhelming staff, inflating budgets, or compromising the quality of service provided to residents? The answer lies not in hiring more staff to handle manual processes, but in strategically embracing automation to create a sustainable, efficient, and compliant system.
The growing administrative challenge ahead
State Medicaid and health services directors and their teams already navigate a complex landscape defined by staffing shortages, high employee turnover, and persistently tight budgets. The introduction of a monthly reporting requirement introduces a new layer of complexity, creating pressure points across four critical areas of operation:
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Unprecedented volume of documentation: The scale of this new requirement is staggering. Each month, potentially hundreds of thousands of people in every state will be required to submit proof of employment, volunteer hours, or educational enrollment. Current systems that rely on mail, fax, or in-person drop-offs were not designed to receive, process, and verify this volume of documentation. Attempting to manage this influx manually is a recipe for backlogs, errors, and lost paperwork, which can directly lead to eligible residents losing their coverage.
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Complex exemption and appeals management: Many individuals may qualify for exemptions from the work requirement due to disability, caregiving responsibilities for a family member, or other valid circumstances. Each of these requests requires a secure intake process, verification of supporting documents, and meticulous tracking. Furthermore, agencies must have a clear and accessible process for managing appeals. Without a streamlined digital workflow, handling these sensitive cases will consume a disproportionate amount of staff time and create a significant compliance risk.
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Rigorous compliance reporting: States must be prepared to demonstrate compliance at any moment. This means providing auditable, comprehensive records to CMS and other state oversight bodies. Relying on spreadsheets, paper files, or disconnected systems makes this nearly impossible. Disorganized or incomplete data not only puts state programs at risk during an audit but can also lead to financial penalties and jeopardize federal funding.
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Inevitable staff burnout: Without automation, the burden of this new mandate will fall squarely on the shoulders of agency program staff. They will be tasked with answering a flood of calls from confused residents, manually processing mountains of paperwork, and troubleshooting endless one-off issues. This diverts their valuable time and expertise away from higher-value work, such as handling complex cases or conducting outreach. The result is a decline in morale, an increase in turnover, and a diminished capacity to serve the public effectively.
The unsustainable cost of manual processes
The traditional approach to government service delivery – relying on mail-based notices, in-person visits, phone calls, and paper submissions – is no longer fiscally or operationally sustainable, especially at the scale required. The cost differential between traditional and digital interactions is dramatic. Granicus research consistently shows that:
- An in-person visit costs an agency approximately $10 per interaction.
- A live phone call with a human agent averages around $8 per interaction.
- A digital interaction, such as a self-service submission or automated notification, costs just 10 cents.
Multiplying these costs by thousands of people every single month makes the financial implications clear. Sticking with manual processes means agencies risk ballooning administrative costs just to maintain baseline compliance, siphoning funds away from direct services and other critical program needs.
Where digital automation makes a tangible difference
Granicus equips Medicaid programs with the tools needed to dramatically reduce manual workload while ensuring ironclad compliance. Through the integrated Government Experience Cloud (GXC), which includes Engagement Cloud and Service Cloud, states can streamline and automate processes from initial outreach to final reporting.
Automated reminders and proactive notifications
A significant portion of administrative work comes from reactive communication, such as answering questions and chasing down missing information. Granicus flips this model by enabling proactive, automated outreach. Agencies can schedule recurring reminders for monthly submissions and exemption renewals, ensuring residents never miss a deadline. By notifying residents of key dates and requirements through their preferred channels — such as SMS, email, and secure web portal overlays — agencies can reduce call center volume by delivering clear, accessible information before they even think to ask.
Secure self-service portals for residents
Empower residents to take control of their compliance. With Granicus, agencies can create secure, mobile-friendly self-service portals where residents can submit documentation online from any device. Digital forms make it easy to manage exemption requests and appeals, with all information flowing directly into a centralized system. Upon submission, the portal can automatically provide a confirmation receipt, giving residents peace of mind and eliminating the need for follow-up calls to check on their status.
Centralized and secure compliance tracking
Where disparate spreadsheets and filing cabinets can lead to bogged-down processes, Granicus logs every outreach, submission, exemption request, and resident interaction automatically in a single, FedRAMP-authorized system. This creates a comprehensive, real-time audit trail. Leadership teams can use intuitive dashboards to track compliance progress across the state, identify potential issues early, and make data-driven decisions. When a request comes from CMS or a legislative body, teams can export detailed reports instantly, demonstrating compliance with confidence and transparency.
Putting it all together: A real-world scenario
Imagine a Medicaid enrollee who needs to submit their monthly work documentation.
With a traditional, manual system, the enrollee receives a letter in the mail, which might get lost. They have to find a way to copy their pay stub, fill out a paper form, and either mail it in or drop it off. If they have questions, they wait on hold to speak with a staff member. Agency staff then must manually receive the form, verify the information, and enter the data into a tracking system. Multiply this inefficient process by tens of thousands, and the administrative strain becomes crippling.
With the Granicus digital-first system, the process becomes much more simplified:
- The enrollee receives a text message and an email reminder a week before their deadline, written in their preferred language.
- They click a link, log into a secure self-service portal on phone or computer and upload a picture of their documentation.
- The system instantly confirms receipt, and they receive a digital confirmation number. If their next submission is missed, an automated follow-up reminder is sent.
In this scenario, the resident’s experience is simple and convenient. More importantly, agency staff is freed from routine paperwork and can focus their energy on complex cases that require human expertise. The result is lower administrative costs, fewer coverage gaps due to administrative errors, and a much stronger compliance record.
The path to sustainable compliance starts now
Agency leaders know firsthand the reality of the situation: resources are limited, timelines are tight, and compliance with federal mandates is non-negotiable. In this environment, digital-first systems are no longer an optional upgrade — they are an essential component of a resilient, modern Medicaid program.
Granicus provides a proven, scalable, and government-ready solution that directly addresses the challenges of OBBBA. Our platform is designed to:
- Cut administrative costs by automating routine communication and data entry.
- Protect and empower your staff by reducing manual workloads and burnout.
- Ensure unwavering compliance with CMS requirements through secure, automated audit trails.
OBBBA will undoubtedly test the operational resilience of every Medicaid program in the country. The agencies that invest in automation and digital transformation today will be the ones best positioned to manage compliance effectively tomorrow without overwhelming their staff or their residents.
Next steps
Don’t wait for the deadline to create an administrative crisis. Learn how Granicus can help your agency reduce the burden of redetermination compliance and build a more efficient and sustainable program for the future.
Contact us today to schedule a consultation and see these solutions in action.
