Government Gains with the New Jersey Innovation Authority

What was the biggest challenge you faced in this project?

Our biggest challenge was to figure out how to digitize and simplify the signup process for doulas interested in being Medicaid providers, an effort that we undertook with agency partners at the New Jersey Department of Human Services (which is responsible for the signup process) as well as the New Jersey Department of Health and the New Jersey Maternal and Infant Health Innovation Authority. We knew that we wanted to do more than just put a 38-page form online, because that alone wouldn’t have actually helped anyone. Doulas told us that form was hard to complete even with help from experts, so we knew there was an opportunity to thoughtfully create a streamlined online process to make it clearer, faster, and better.

We needed to reimagine the signup process while also staying aligned with policy, legal, and administrative stakeholders. That meant building a case for a better workflow that worked for everyone—doulas as well as our agency partners who were receiving the form—while also keeping the door open for expansion and iteration.

How did you approach this challenge and how did you decide which tools to use to solve it?

Our small but mighty team cast a wide research-and-discovery net to understand the landscape. We heard from: doulas who had submitted Medicaid forms, doula guides who support the doula community, agency staff who process the forms that doulas fill out, and managed care organizations that interact with doulas after they sign up.

From there, we workshopped problem statements and prioritized, using digital collaboration tools. We synthesized pain points that doulas identified, honing in on the Medicaid Fee-for-Service application and the specific people who use that form. 

Narrowing the scope to doulas practicing as sole proprietors was a key decision. They're the largest segment of doulas seeking to become Medicaid providers, so we tailored the workflow of our MVP specifically to them instead of designing something significantly more complex for relatively few additional users.

From there, the real work was conversation. With the help of our agency partners, we workshopped how to simplify the form and proposed new, streamlined approaches. The tools that mattered most weren't software; they were the research, prioritization, and alignment efforts that got everyone rowing in the same direction.

Where will the lessons you learned here be applied in the future?

The stars don't need to align perfectly to simplify a complicated paper process. Concrete user feedback along with data from agency partners can carry a lot of weight when you're proposing a new approach, often more than any top-down mandate would.

Breaking down a form, a user feedback loop, and an application process into individual pieces goes a long way toward making an overwhelming problem solvable. Instead of asking "how do we fix this 38-page form," we asked smaller questions: Who is actually filling this out? What are they stuck on? And, what does the agency actually need to see in submitted forms? Each smaller question had an answerable solution.

We're carrying that approach into other digitization efforts. Start narrow, prove the model with a specific audience, and expand from there, rather than trying to solve for every possible applicant on day one. And keep the people who process the form, not just the people who submit it, in the room from the start, because buy-in from everyone is what makes a redesign stick after the project team moves on.