Tennessee Justice Center (TJC) is a leading non-profit community interest law firm that works to help vulnerable, low income clients (children and adults) access the necessities of life like healthcare. Every year the TJC helps hundreds of families navigate eligibility in the complex world of Medicaid. Determining an individual’s eligibility is extremely complicated and training staff, interns and volunteers (called “client advocates”) to navigate this system was daunting. TJC engaged Virsys12 to create AskJane!, a reliable, highly complex but efficient eligibility calculator, that systematically categorizes applicants, identifies potential coverage, and calculates eligibility. AskJane! has reduced the time it takes to train a client advocate by 75% and delivered over $6.6 million in healthcare value to individual clients— a 45% increase year over year. The team is discussing how to adapt it for other states as well.
Tennessee Justice Center (TJC) is a leading non-profit community interest law firm that works to help vulnerable, low income Tennesseans. Much of TJC’s work focuses on helping their clients (children and adults) gain access to healthcare by navigating the application for eligibility in the complex world of Medicaid.
In the 22 years since its inception, TJC has secured $2 billion in health benefits for individuals. In 2017, TJC trained and supported a network of community partners that helped more than 44,600 Tennesseans gain affordable health care.
As healthcare changes, technology provides answers
As the saying goes, “If you’ve seen one Medicaid program, you’ve seen one Medicaid program.” The standards for eligibility and the programs themselves vary widely state to state and evolve as laws change. When the Affordable Care Act (ACA) was established, it attempted to streamline categories for enrollment across the country by basing eligibility on Modified Adjusted Gross Income, or MAGI for certain categories.
Determining an individual’s MAGI is extremely complex. In Tennessee, there are 123 different sources of income that must be considered for eligibility under its TennCare system. For TJC, training staff, interns and volunteers (called “client advocates”) to navigate this system and ensure accuracy on every application was daunting.
Rob Watkins, a TJC staff attorney discovered the challenges through his own experience as a volunteer, immediately realizing they needed a technology tool to make the process more intuitive. “I thought there must be a way to ask questions so that the answer leads you to the next logical question without having to be an expert in Medicaid or the governing IRS rules,” he explains.
TJC engaged Salesforce Gold Consulting Partner Virsys12 to collaborate on a solution. The result is AskJane! a reliable, highly complex but efficient eligibility calculator, built on the Salesforce platform. Using a series of questions, AskJane! systematically categorizes applicants, identifies potential coverage, and calculates eligibility. The decision tree, logic-based flow solution boasts a “TurboTax-like” user interface, providing client advocates with critical questions to ask applicants to determine eligibility.
AskJane! screens not only for TennCare eligibility but also Medicare savings plans, premium tax credits and cost sharing reductions. It also alerts the client advocate when to seek additional technical assistance from the TJC staff for those cases that will require further analysis and ongoing monitoring.
“Our vison for AskJane! is to take our specific knowledge and understanding of public health benefits and make it widely available to others who intersect with our constituency base,” explains Watkins.
“Virsys12 and their talented staff immediately understood the challenge and need, and they have been a true partner in making our vision a reality using the Salesforce platform.” -Rob Watkins, TJC Staff Attorney
Innovative technology and societal impact – an award-winning combination
Released in-house as a beta project in January 2017, AskJane! quickly proved extremely successful.
AskJane! has reduced the time it takes to train a client advocate by 75%. What used to take twelve months, now takes only three according to TJC. This allows more to be trained and more clients helped.
This reduction in training time has allowed client advocates to successfully close more than double the number of individual cases previously possible. TJC delivered over $6.6 million in healthcare value to individual clients— a 45% increase — and over $1.8 million in reimbursements to healthcare providers.
Due to the impact of AskJane!, TJC received both the Frist Foundation Innovation in Action Award and The Healing Trust Catalyst for Change Award in 2017. Watkins has been nominated as the 2018 Innovator of the Year by the Nashville Technology Council.
Designed to be flexible and scalable
Though AskJane! was designed to help navigate Medicaid eligibility under the ACA, the solution is flexible enough to handle whatever changes may come to the law, an important factor considering the volatility and uncertainty in the U.S. healthcare market. This flexibility will also enable TJC to scale the solution to benefit other organizations, including low-budget nonprofits and potential large-budget hospital systems in the future. The team is discussing how to adapt it for other states as well.
“With the application and eligibility piece streamlined by AskJane!, not only do more people get help, but we are able to identify trends and systemic issues and take them to the state to work on comprehensive solutions,” says Watkins.
This learning and improvements will continue as the technology reveals the previously untracked data for effective decisions. And Tennessee Justice Center will continue their mission to help people gain access to the necessities of life, including healthcare.
“Virsys12 and their talented staff immediately understood the challenge and need, and they have been a true partner in making our vision a reality using the Salesforce platform.” - -Rob Watkins,, TJC Staff Attorney
• 75% reduction in client advocate training time
• 45% increase in healthcare benefit value received
• 100%+ increase in eligibility applications completed
• Multi-award-winning solution
• Flexible, scalable and proven
A Multi Award-Winning Solution:
• Frist Foundation Innovation in
Action Award, 2017
• The Healing Trust Catalyst for
Change Award, 2017
• 2018 Innovator of the Year
nomination for Rob Watkins by
the Nashville Technology Council