McKinsey and Celonis share insights on how to rethink Human Services and integrated eligibility in response to H.R. 1

In July 2025, H.R. 1 was signed into law, affecting two major health and Human Services programs. These are Medicaid – a federal-state program that provides health coverage to low-income individuals, families, children, pregnant women, the elderly, and people with disabilities – and the Supplemental Nutrition Assistance Program (SNAP), which provides food assistance for those with low income.

Human Services agencies have had to radically reimagine their delivery model ever since H.R. 1 passed, so Mark Fellows, Sales Director of State and Local Government at Celonis, hosted a webinar to explore the impact of the different H.R. 1 policies. He was joined by:

• Sarah Miller, McKinsey partner and leader in the social, health care, and public sector practice
• Wesley Merritt, founder of Merritt Solutions LLC, and the former assistant deputy commissioner at Georgia Department of Human Services
• Corey Edson, Lead Value Engineer at Celonis, who specializes in state and local transformation initiatives

Miller began the webinar by explaining that Human Services providers face new requirements for states to pay some of the cost of SNAP benefits if their payment error rate (PER) exceeds 6%. This cost-sharing requirement can amount to millions – even billions – of dollars annually for states, depending on the size of their SNAP population.

However, Miller emphasized how avoiding these penalties is easier said than done, as workers’ caseloads have increased due to new eligibility checks, waiver restrictions, and expanded work requirement criteria for “able-bodied adults without dependents” (ABAWDs).

So how can Human Services organizations successfully adapt and meet the requirements of H.R. 1 for Medicaid and SNAP programs? Here are the golden-nugget takeaways that will help the public sector rethink Human Services and integrated eligibility in response to H.R. 1.

The role of processes in Human Services agencies

First, Edson outlined the challenge Human Services providers face.

Federal guidance for improving timeliness and accuracy is process-centric, recommending methods like root cause analysis, quality assurance reviews, and data system and technology enhancements as primary levers to improve metrics like program integrity and PER.

But traditional approaches to these activities are time-intensive, subjective, and impractical. They also only provide one-time snapshots of how the organization is running, so a core challenge for Human Services providers is a lack of accurate, real-time visibility into their processes and operations.

To take SNAP programs as an example, the ideal sequence of steps might be registration, verification, an interview, and ultimately an eligibility decision. But in reality, as policy evolves, the SNAP eligibility process can grow much more complex due to tons of variations, such as a SNAP/Medicaid combination case, often involving several family members. This complexity can lead to inefficiencies in eligibility processes and missed opportunities to improve accuracy and timeliness.

Addressing PER and program integrity therefore requires intimate knowledge of how Human Services processes operate. Not how they’re documented, not how stakeholders think they work – but how they actually run across systems, counties, and workers.

How Celonis supports Human Services agencies and the public sector

Edson went on to explain how Celonis helps Human Services agencies make their processes work – for both their organizations and the people they’re serving.

The Celonis Process Intelligence Platform integrates with an agency’s existing tech stack: their eligibility system, EBT distribution system, workflow tools, and anything else within the case lifecycle. It enables agencies to extract process data from these systems and enriches it with deep context to create a living digital twin of their operations – the Process Intelligence Graph. On top of the graph, the Platform provides capabilities to analyze, design, and operate composable, AI-driven processes. Human Services agencies can use the Platform for:

• Process analysis – to understand variations, bottlenecks, and error-drivers
• Process improvement – to recommend and design solutions based on facts, not assumptions
• Process monitoring – to get real-time visibility into performance and compliance
• Process orchestration – to feed third-party AI models, copilots, and orchestration tools with the context of how the process actually runs

The webinar participants then shared how Celonis works across the Human Services case lifecycle, through several lenses:

It starts with the case itself

The backbone of the eligibility process is the customer’s complete case history. By following it across systems, agencies can see how long a case takes to move from intake to determination, where it gets held up, and how different caseworkers and counties impact timing and accuracy.

Then there’s the application

Applications tend to follow different paths depending on household complexity or types of assistance. Celonis lets agencies break down these variations and understand where common sources of rework or errors originate.

Next up are tasks

Tasks are the operational heartbeat of the eligibility process and ultimately where all the work gets done – think verification requests, case updates, document reviews, and notices. By analyzing them in Celonis, agencies can identify workload imbalances, aging tasks, reassignments, and differences in how quickly tasks are completed by region and workforce.

After that there are periodic reports and renewals

Periodic reports are major drivers of payment accuracy, while metrics like churn are affected by customers falling out of the renewal process. With Celonis, agencies can detect why some reporting processes run smoothly and others don’t, so they can better understand how to operationalize change.

And finally, there are EBT cards and Medicaid claims

Electronic benefit transfer (EBT) cards and Medicaid claims are perfect examples of parts of the case lifecycle that often exist in completely different systems to the eligibility system. Once agencies can see case application tasks, reports, renewals, EBT card activity, and even Medicaid claims in one end-to-end view, they can immediately understand – then simplify – the true complexity of the eligibility process and customer journey.

By analyzing all these steps, agencies can pinpoint which events and deviations lead to payment errors, with root causes including inconsistent determinations, sequencing issues where events happen in the wrong order, and policy violations. Organizations can also explore throughput time, revealing where the process is moving too quickly – potentially skipping critical due diligence steps – or too slowly – creating bottlenecks.

Celonis enables agencies to uncover ways of not just improving program integrity and accuracy, but the customer and employee experience as well. These opportunities include identifying how many times a customer is contacted, as well as where they churn. And Celonis intelligently surfaces improvement opportunities based on the process context, helping the organization focus on the issues that matter most.

Additionally, for states that are locally administered, the Celonis Platform automatically highlights where errors most commonly occur at the county level, and the specific drivers behind them, such as misalignment in caseworker assignment, failure to follow up, or improper budgeting. This insight also serves as the foundation for predictive analytics to prevent future errors, based on historic trends.

Clearly connecting the dots between root cause and outcome, and consolidating cross-system interactions into a single view, is almost impossible with traditional service delivery reporting. Which is what makes Celonis so powerful for continuously minimizing payment errors and increasing program integrity.

To put everything the webinar attendees had heard into context, the webinar participants discussed how Celonis has helped the Georgia Department of Human Services.

Integrated eligibility in practice: The Georgia Department of Human Services

Merritt shared how the Georgia Department of Human Services (GA DHS) wanted to improve service delivery for vulnerable citizens, while optimizing workforce planning given the state’s limited resource allocation. Key metrics included improving application processing timeliness (APT) rate by at least 5% in six months, and reducing PER to 6%. But with limited visibility into process deviations affecting APT rate, and difficulty getting reliable data from reporting units, they had a challenge on their hands. Until they brought in Celonis.

Connecting the GA DHS’ integrated eligibility system to Celonis was a gamechanger for SNAP, Medicaid, and TANF process observability and improvement. By extracting operational data from their eligibility system, then enriching it with AI and institutional context, Celonis provided a true picture of how the eligibility process was running in the form of a digital twin. This showed the GA DHS all the paths that an application could take. For example, the expedited SNAP process, which provides benefits within 7 days for certain households, was being executed over 100,000 different ways.

Celonis also illuminated all the bottlenecks, handoffs, and touches that caused errors and delays. These included a significant wait time between case approval and authorization, which the GA DHS were able to investigate and rectify. Since the Celonis go-live in August 2025, GA DHS has seen a boost in their SNAP APT rate from 79% to 86%, while slashing Medicaid processing time from 31 to 13 days.

Rather than having to consult numerous reports, the GA DHS team gained reliable, actionable insights straight from the source. And they were able to automate workforce planning and service delivery reporting to save the daily morning routine of pulling them manually.

These highlights give you just a flavor of the GA DHS’ success story. Catch up on the full on-demand webinar for:

• More of Merritt’s first-hand insights on how Celonis helped improve auditability, reporting reliability, and continuous improvement for GA DHS
• Miller’s comprehensive breakdown of H.R. 1’s implications for Human Services organizations
• Edson’s deep dive into the Celonis Platform that illustrates what makes it the ideal companion for process optimization in the public sector.