We’re thrilled to welcome Stephanie Bell to Vimo® as our new Medicaid Innovation and Policy Strategist! Stephanie brings a wealth of experience in Medicaid policy, having played a key role in implementing the Affordable Care Act’s Medicaid expansions, redesigning cost-sharing policies, and spearheading regulatory guidance at CMS. With deep expertise in Medicaid eligibility, enrollment, and program innovation, she’s been at the forefront of shaping state and federal health policy for over a decade.
At Vimo, Stephanie will help drive Medicaid innovation, working alongside states to create flexible, consumer-focused solutions that improve access and efficiency. Learn more about Stephanie in the Q+A below.
Can you share a bit about your background and what led you to work in Medicaid policy and innovation?
My love of health care policy really started in graduate school with an introduction to health policy class. I was working on my Master’s in Social Welfare at UC Berkeley. Then I was accepted into the Presidential Management Fellowship program, which was an incredible opportunity to try out federal service. I expected to stay for only a few years, but once I started working on my first federal regulation, I was hooked. I loved the process of gathering information to address policy challenges, digging into the statutory requirements, developing new ideas, collaborating with other offices and departments to obtain feedback, and then getting input from public comments. I worked in several parts of the Department of Health and Human Services before I got to the Center for Medicaid & CHIP Services at CMS where I got to marry my love of health policy with my passion for social welfare.
You’ve had an incredible career in both federal and state health policy—what’s a standout moment or accomplishment that you’re particularly proud of?
One of my favorite accomplishments was work I did with the Federal Communications Commission (FCC) to provide state Medicaid agencies with guidance on the use of text messaging to their beneficiaries. It started with concerns from states about their ability to conduct outreach to beneficiaries at the end of the COVID-19 Public Health Emergency about the need to renew their Medicaid eligibility. States were concerned about the implications of the Telephone Consumer Protection Act (TCPA) on their ability, and that of their partners, to send text messages to beneficiaries. As the lead staff person working on this issue for CMS, I got to learn a completely new policy area, connect with staff members at the FCC to understand their policies and processes, and draft policy papers and correspondence for use by the Secretary of Health and Human Services. Once we understood the needs of state agencies and their partners/contractors, as well as the implications of these needs for other parties subject to the same requirements, we were able to find common ground and the FCC issued a declaratory ruling that relieved some of the states’ concerns.
Throughout your time at CMS, you’ve driven major regulatory and policy changes. What are some key lessons you’ve learned about shaping effective Medicaid programs?
One of the most wonderful things about Medicaid is that every state and territory has tremendous flexibility in the design and implementation of their Medicaid program, both within existing federal requirements and through demonstration programs. At the same time, as the program evolved over almost 60 years, it has become increasingly complex. When you combine that complex structure with the flexibility available to states, it can be really difficult to wrap your arms around all of the requirements and options available in any specific area of the program. I spent almost 15 years working on eligibility and enrollment and I was still learning new things every day. This leads me to believe that there are countless untapped opportunities out there to make small changes to Medicaid programs, which could vastly improve their processes – making it easier for eligible people to enroll and stay enrolled in Medicaid while reducing the administrative burden on states.
What drew you to this opportunity at Vimo, and what excites you most about the work ahead?
During my time at CMS, I developed a strong understanding of the federal requirements and the federal processes that shape state Medicaid and CHIP programs, particularly eligibility and enrollment. I also recognized how hard it can be to take those requirements and turn them into functional systems that gather all of the information needed from individuals and families to correctly and efficiently determine their eligibility for Medicaid along with CHIP, the Basic Health Program (where available) and coverage through the Marketplace. I really wanted to take my knowledge of the requirements and use them to help build better systems for states. I was so excited to learn about the incredible work Vimo is doing to build state-based marketplace technology that not only works well but also makes it easier for people to apply and renew their coverage. Then when I learned about the amazing work Vimo is doing with state health and human services agencies, through Change and Innovation Agency (C!A®), to improve their processes, it seemed like the perfect opportunity. I am excited to learn from the states with which we work – about their challenges, their successes, and their specific needs – and then to work with the incredible team here to turn that knowledge into actionable changes that could really make a difference.
How do you see your experience in Medicaid eligibility, enrollment, and innovation shaping your approach in this role?
Over nearly 15 years at CMS, I became increasingly comfortable with how little I really know about health care policy and how much I enjoy finding the experts and learning from them. I love to learn, to ask questions, to dig into the history of policies and processes, and to consider new ways of thinking about things. I am so excited to approach health care policy from a new perspective here at Vimo and to have the opportunity to work with and learn from so many experts both within the agency and without. I believe almost any problem can be solved if you take the time to really understand the problem and its implications and to think creatively about different ways to approach resolution.
What are some of the biggest challenges or opportunities in Medicaid policy right now, and how do you hope to tackle them with Vimo?
I believe we learned a lot from implementing the Affordable Care Act about how to leverage technology to improve the process of applying for health coverage, verifying eligibility, and renewing enrollment of eligible individuals. While states created online applications and built electronic verifications into their processes, many people still think about eligibility and enrollment the same way they did when it was a paper-based process with an eligibility worker collecting information in a file folder. This leaves states with one foot in technology and one foot in the traditional paper-based process. This may explain why the leading cause of eligibility-related improper payments in Medicaid and CHIP is insufficient documentation. When an auditor reviews a case-file to determine whether the individual was eligible at the time a claim was paid, they may be expecting to see traditional documentation of eligibility verification, like copies of pay stubs from the last eligibility determination. As states work to transition all of their Medicaid and CHIP eligibility records to electronic format in accordance with eligibility requirements finalized in 2024, they have an opportunity to rethink their processes too. The result could be huge improvements in program integrity with no negative impact on enrollment and retention of eligible individuals and families.
What is a piece of advice you’ve received in your career that has stuck with you?
One of my favorite mentors told me never to take a job without knowing when I was going to leave it. While I never took that advice literally, I have used it throughout my career to continue to set new goals and objectives for myself. Pausing to think about what’s needed in my job and how I can stretch myself in the coming months allows me to turn my work into something new and fresh every single year.
Recent Comments