Restoring Program Integrity: A Benefit Recovery Performance Assessment for the State of Florida.

About the Client

DCF is the Florida state agency responsible for administering public assistance, child welfare, and behavioral health services statewide, with headquarters in Tallahassee. Within DCF, the Office of Public Benefits Integrity is charged with preventing, detecting, and recovering waste, fraud, and abuse across the state’s food, cash, and medical assistance programs. Its Benefit Recovery Unit investigates suspected overpayments, establishes claims, and manages collections once an overpayment has been confirmed — work carried out in partnership with the state’s Division of Public Assistance Fraud and an outsourced collections vendor, as required by Florida statute.

Industry Context

Improper payments are a persistent, multi-billion-dollar challenge across the U.S. public benefits landscape. Federal reporting has repeatedly shown SNAP overpayment rates in the high single digits and Medicaid improper-payment rates exceeding 5 percent of outlays, with combined SNAP and Medicaid improper payments regularly exceeding $40 billion in a single year. Program integrity has become a recurring focus of federal oversight and legislation, pushing agencies toward data-driven eligibility verification, cross-program data matching, and increasingly automated fraud analytics rather than the manual, paper-intensive recovery processes that were still standard in many states a decade ago.

Current Situation

BRU’s referral backlog had grown to 43,640 unworked claims — roughly a full year’s worth of casework — an increase of 58 percent in a single year. The uncollected claims underlying that backlog were valued at more than $14 million. At the same time, the unit faced anticipated headcount reductions of 24 percent, even as its caseload load-bearing system, the Integrated Benefit Recovery System (IBRS), had not been updated with formal staff training since its 2006 implementation. BRU’s executive leadership recognized that continuing on the same trajectory was untenable and sought an independent, evidence-based assessment of the unit’s people, processes, policies, and technology.

BRU’s leadership needed to understand not just that performance was declining, but precisely why — and what a credible path back to program integrity would require. Three compounding issues stood out:

• Structural misalignment. BRU’s organizational design had not kept pace with its workload, and management lacked the accurate, timely information needed to make staffing and prioritization decisions.
• Manual, inconsistent operations. Core recovery work was performed largely by hand, personnel and processes were not managed consistently, and the unit’s outsourced collections partner, Public Consulting Group (PCG), was constrained from performing effective collections under the existing operating model.
• Procedural drag. Florida’s Intentional Program Violation (IPV) adjudication process introduced significant delays into the recovery pipeline, and BRU lacked several of the case-management tools that peer states were already using to manage comparable workloads.

• Assess BRU’s core business processes, performance goals and measures, policies and procedures, and organizational structure.
• Benchmark BRU’s operations against comparable state benefit-recovery programs and applicable federal guidance.
• Quantify the scale and root causes of the claims backlog using BRU’s own transaction data.
• Identify concrete opportunities for outsourcing, automation, and process redesign, and translate them into a prioritized, actionable roadmap.

How Iknow Structured the Work

Iknow applied a structured, evidence-first assessment methodology: gather primary evidence directly from the people doing the work and the data generated by that work, validate findings against external benchmarks, and translate findings into a prioritized, financially quantified set of recommendations that executive leadership could act on immediately.

Key Activities & Decisions

• Stakeholder Interviews. Iknow conducted 70 in-person individual and group interviews with BRU and Division of Public Assistance Fraud staff, the state Attorney General’s office, and program representatives from USDA Food & Nutrition Service and the Centers for Medicare & Medicaid Services.
• Multi-State Benchmarking. The team interviewed HHS counterparts in Texas, Georgia, Mississippi, Connecticut, and Pennsylvania to identify recovery practices, staffing models, and technologies that outperformed Florida’s.
• Large-Scale Data Analysis. Iknow extracted and analyzed nearly two million records spanning six years of SNAP, TANF, and Medicaid transaction and financial data from IBRS to quantify backlog drivers, claim aging, and collection performance.
• Findings and Recommendations Reporting. The team documented its findings in a 200-plus-page Findings Report and a 60-plus-page Recommendations Report, and translated the recommendations into a Leadership Action Items spreadsheet with an associated benefit case for each initiative.

Stakeholders & Collaboration

Iknow worked as a subcontractor to The Stephen Group, reporting jointly to BRU’s executive team while coordinating directly with DCF program staff, the Division of Public Assistance Fraud, PCG, and federal program representatives — a stakeholder set spanning state and federal government, law enforcement, and a commercial collections vendor.

Building an Evidence Base Under Time Pressure

A three-month engagement window left little room for a shallow analysis. Iknow addressed this by running interviews, benchmarking calls, and the six-year data extraction from IBRS in parallel rather than sequentially, allowing findings from each workstream to sharpen the questions asked in the others and ensuring the final recommendations were grounded in both qualitative and quantitative evidence.

Translating Findings Into Actionable, Fundable Recommendations

A list of process gaps alone would not move a resource-constrained state agency to act. Iknow grouped more than 60 discrete improvement opportunities into four priority areas — improved collection activity, enhanced claiming, backlog reduction, and cost avoidance — and paired each with a documented benefit case, giving BRU’s leadership the specific, defensible justification needed to pursue funding, reorganization, and legislative support.

Operational Outcomes

• Delivered a prioritized portfolio of more than 60 improvement opportunities, each mapped to one of four strategic priorities: improved collection activity, enhanced claiming, backlog reduction, and cost avoidance.
• Established the current-state performance baseline BRU needed to track improvement going forward, with an explicit target of doubling recovery performance within 24 months.
• Identified a pipeline of near-term “mini-IT” projects to work around IBRS limitations, prioritizing management of late payments.

Strategic and Organizational Outcomes

The assessment directly informed BRU’s decision to reorganize the unit, re-procure its outsourced collections vendor to secure a stronger enhanced-collections partnership, and pursue the regulatory and legislative support needed to remove structural barriers to effective recovery — the three headline actions BRU’s leadership committed to following the engagement.

Timeline to Impact

Iknow delivered its findings, recommendations, and leadership action plan within the four-month engagement window, giving BRU’s executive team a ready-to-execute roadmap immediately following project close-out.

Core Skills

• Operational & Process Assessment
• Business Process Redesign / Reengineering
• Benchmarking
• Performance Management & KPI Design
• Organizational Design Advisory

Methods & Frameworks

• Current-state assessment and root cause analysis
• Cross-state (peer) benchmarking
• Large-scale transaction data analysis
• Benefit-based prioritization of improvement initiatives

Technologies & Tools

• Integrated Benefit Recovery System (IBRS) data extraction and analysis