Upturn
@upturn.org
Upturn advances equity and justice in the design, governance, and use of technology.
https://www.upturn.org
https://www.upturn.org
8/ We hope our report can support the important harm reduction work advocates are already doing in fighting automated determinations. We also believe in building towards the bigger fight for a system of universal care, which is the only way everyone can get the care they need.
Calculated Need: Algorithms and the Fight for Medicaid Home Care
Upturn advances equity and justice in the design, governance, and use of technology.
www.upturn.org
October 21, 2025 at 6:26 PM
8/ We hope our report can support the important harm reduction work advocates are already doing in fighting automated determinations. We also believe in building towards the bigger fight for a system of universal care, which is the only way everyone can get the care they need.
7/ Based on our work with advocates, we developed an "advocacy tools" section of our report to help those seeking to access, analyze, and understand the algorithms used in their state, and to ask broader political questions in relation to these tools.
Calculated Need: Algorithms and the Fight for Medicaid Home Care
Upturn advances equity and justice in the design, governance, and use of technology.
www.upturn.org
October 21, 2025 at 6:26 PM
7/ Based on our work with advocates, we developed an "advocacy tools" section of our report to help those seeking to access, analyze, and understand the algorithms used in their state, and to ask broader political questions in relation to these tools.
6/ In Missouri, the only state in our report that publicly released its eligibility algorithm, we worked with Legal Services of Eastern Missouri to assess an earlier version of the algorithm back in 2019, which led to important fixes that reduced the algorithm’s harms. www.btah.org/case-study/m...
Missouri Medicaid Home and Community Based Services Eligibility Issues
The Benefits Tech Advocacy Hub brings together legal and technical expertise to fight for access to public benefits and to make sure technology does not limit that access.
www.btah.org
October 21, 2025 at 6:26 PM
6/ In Missouri, the only state in our report that publicly released its eligibility algorithm, we worked with Legal Services of Eastern Missouri to assess an earlier version of the algorithm back in 2019, which led to important fixes that reduced the algorithm’s harms. www.btah.org/case-study/m...
5/ Separately, when DC redesigned its eligibility process, the DC agency cited the constraints of its vendor's assessment tools as a way to dismiss advocates’ concerns about new eligibility rules, showing how the influence of vendors can undercut due process. www.upturn.org/work/calcula...
October 21, 2025 at 6:26 PM
5/ Separately, when DC redesigned its eligibility process, the DC agency cited the constraints of its vendor's assessment tools as a way to dismiss advocates’ concerns about new eligibility rules, showing how the influence of vendors can undercut due process. www.upturn.org/work/calcula...
4/ Meeting minutes from Nebraska, obtained through public records, pull back the curtain on how the state agency and vendors jointly designed its home care eligibility algorithm. The minutes even stated that “the idea of… eligibility being clear cut is a myth.” www.upturn.org/work/calcula...
October 21, 2025 at 6:26 PM
4/ Meeting minutes from Nebraska, obtained through public records, pull back the curtain on how the state agency and vendors jointly designed its home care eligibility algorithm. The minutes even stated that “the idea of… eligibility being clear cut is a myth.” www.upturn.org/work/calcula...
3/ There’s no escaping the fact that these automated Medicaid eligibility determinations are arbitrary and subjective: based on our analysis, someone who is eligible for home care in Mississippi and Nebraska could be *ineligible* in Missouri, New Jersey, and DC.
Calculated Need: Algorithms and the Fight for Medicaid Home Care
Upturn advances equity and justice in the design, governance, and use of technology.
www.upturn.org
October 21, 2025 at 6:26 PM
3/ There’s no escaping the fact that these automated Medicaid eligibility determinations are arbitrary and subjective: based on our analysis, someone who is eligible for home care in Mississippi and Nebraska could be *ineligible* in Missouri, New Jersey, and DC.
2/ Our report offers an in-depth analysis of five states’ eligibility algorithms, case studies on how states work with vendors to develop their algorithms, and historical research on the emergence of the federally mandated eligibility standard for Medicaid home care.
Calculated Need: Algorithms and the Fight for Medicaid Home Care
Upturn advances equity and justice in the design, governance, and use of technology.
www.upturn.org
October 21, 2025 at 6:26 PM
2/ Our report offers an in-depth analysis of five states’ eligibility algorithms, case studies on how states work with vendors to develop their algorithms, and historical research on the emergence of the federally mandated eligibility standard for Medicaid home care.
The search for Upturn’s next Executive Director starts today!
We're seeking candidates with 10+ years of experience and a commitment to advancing equity & justice, who can guide Upturn’s long-term political vision and continue to grow the institution. Apply by Nov 24: www.upturn.org/join/executi...
We're seeking candidates with 10+ years of experience and a commitment to advancing equity & justice, who can guide Upturn’s long-term political vision and continue to grow the institution. Apply by Nov 24: www.upturn.org/join/executi...
Upturn Seeks an Executive Director
Upturn advances equity and justice in the design, governance, and use of technology.
www.upturn.org
October 8, 2025 at 9:05 PM
The search for Upturn’s next Executive Director starts today!
We're seeking candidates with 10+ years of experience and a commitment to advancing equity & justice, who can guide Upturn’s long-term political vision and continue to grow the institution. Apply by Nov 24: www.upturn.org/join/executi...
We're seeking candidates with 10+ years of experience and a commitment to advancing equity & justice, who can guide Upturn’s long-term political vision and continue to grow the institution. Apply by Nov 24: www.upturn.org/join/executi...