The systems that our client relies upon to provide health care benefits to state residents were suddenly facing immediate transformation imperatives. The Affordable Care Act was on the cusp of being implemented, in itself reshaping the state’s medical marketplace. The state had committed to both creating a health-insurance exchange as well as modernizing their entire human services delivery platform. Public, private, and customer pressures were mounting. The state’s 25-year-old existing mainframe system wasn’t up to the challenge. 

This confluence of events and pressures, however, also presented opportunity. The state’s Department of Human Services decided to modernize its systems and processes with a world-class platform that would create efficiencies for Medicaid and future projects. 

Meanwhile, the deadline loomed. A project that typically could require up to 36 months to implement had a window of only eight-and-a-half months to meet the Federal deadline to have both the health-insurance exchange and Medicaid systems in place. In that short time frame, the team had to implement a new Medicaid eligibility determination and case management system that could integrate seamlessly with the new Health Insurance Exchange and transfer about 275,000 active Medicaid cases from the legacy system. The state’s residents depended on our team to help get these systems to where they needed to be.