American Healthcare Department Transforms Efficiency of State Programs

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CLIENT

 

The client is a United States (US) health exchange department that required technical support for 14 of its state programs as well as its existing data system platform. It was looking to enable government programs to keep pace with changes in the healthcare industry.

BUSINESS CHALLENGE

 

US state-run healthcare programs required a technological transformation to keep pace with the private healthcare industry. For the client, this meant a complete upgradation of its current system. This transformation included: integration with exchanges, upgradation of verification methods for government entities, refurbishment of frameworks, and reduction of total cost of ownership for applications with legacy technologies.

SOLUTION

 

Our team devised a solution that included the following:

• Product development and implementation

• Reform changes

• Operation optimization

BENEFITS

The solution enabled the client to:

 

• Develop and implement Hewlett Packard interchange

• Integrate with other tools like healthcare portals and Atlantes

• Implement immunization registries

• Upgrade technologies such as Medicaid Information Technology Architecture (MITA) 2.0 and 3.0

• Create state plan amendments as part of the Affordable Care Act (ACA)

• Establish MAGI (Modified Adjusted Gross Income) conversion plans and MAGI-based eligibility implementations

• Verify eligibility through social security administration, department of homeland security, and labor

• Ensure uniform enrollment integration through exchanges

• Support Medicaid Management Information System (MMIS) takeover and transitions

• Save costs through a common IT program with resource factory models

• Work with states for certifications and compliance thereby reducing turnaround time