Summary

This is an operational dashboard document from MAXIMUS tracking call center and case management metrics for Indiana's health benefit programs over a six-month period from January through June 2026. The file monitors performance across multiple Medicaid-related programs including Hoosier Healthwise (HHW), Hoosier Care Connect (HCC), Healthy Indiana Plan (HIP), and Indiana PathWays for Aging. The dashboard captures inbound call volumes by program, categorizes calls by reason (such as education, referrals, eligibility inquiries, and plan selection), tracks just cause (JC) request processing, and documents complaints by entity. Total monthly calls range from approximately 2,627 to 7,368 across all programs, with HIP consistently generating the highest volume. The document provides detailed breakdowns of the top ten inbound call reasons for each program and tracks managed care entity (MCE) performance including Anthem, CareSource, Managed Health Services (MHS), and United Healthcare.

The dashboard includes comprehensive tracking of just cause request approvals, denials, and pending cases across MCEs, with processing metrics showing approval rates, denial rates, invalid or withdrawn requests, and pending case counts. The data reveals operational performance trends, such as the May 2026 introduction of an "Auto Approved" category for certain JC requests, resulting in 227 total auto approvals that month and escalating to 1,223 in June. Complaint data is documented by entity, with most entities reporting zero to minimal complaints throughout the period. The document serves as an internal performance monitoring tool for the state's Medicaid administration, enabling tracking of call center operations, case processing efficiency, and managed care plan performance metrics across all program lines.