iiinova — where your digital self keeps evolving

Upturn

@upturn.org

Upturn advances equity and justice in the design, governance, and use of technology. www.upturn.org

Upturn @upturn.org · 21/10/2025

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...

An outline of the District of Columbia labeled "State: DC Council; Department of Health Care Finance" and "Vendors: interRAI; FEI Systems."

100

Upturn @upturn.org · 21/10/2025

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...

An outline of the state of Nebraska labeled "State: Nebraska Department of Health and Human Services" and "Vendors: Optumas; interRAI."

100

Upturn @upturn.org · 21/10/2025

1/ NEW: Read our new report, “Calculated Need: Algorithms and the Fight for Medicaid Home Care.” We show how automated eligibility determinations are political tools that draw a subjective line between who is deserving and undeserving of getting care in their home. www.upturn.org/work/calcula...

Cover of Upturn's new report titled "Calculated Need: Algorithms and the Fight for Medicaid Home Care. A Comparison of Five States' Eligibility Algorithms." The authors are Miriam Osman, Emily Paul, and Emma Weil. Published in October 2025.

127