John Joaquin, EY | Modernizing a State Medicaid Agency’s Technology Platforms

Summary

The transcript discusses the modernization journey of a state Medicaid agency, facing challenges with outdated technology. The agency aimed to enhance user experience and meet federal mandates by adopting a web-based platform, ServiceNow, chosen for its market-proven capabilities. EY was selected to implement the new system, focusing on business process expertise and technical knowledge. The modernization resulted in a more user-friendly, efficient system, reducing costs and improving data accuracy, setting a precedent for other public sector entities.

Takeaways

• 🏥 Government agencies are under pressure to modernize due to aging technology platforms and public expectations for better services.
• 🔄 The state Medicaid agency aimed to modernize to provide a consumer-like experience for its members, moving away from legacy systems dating back to the 1960s.
• 💻 The federal government encourages system modernization with incentives, emphasizing cost-effectiveness and risk reduction.
• 🛠️ ServiceNow was chosen as the platform for modernization due to its market-proven capabilities and the ability to integrate various systems through a common interface.
• 🏢 EY was selected to lead the modernization process due to its demonstrated ability to handle complex system modernizations and manage organizational change.
• 🔑 The modernization focused on creating a web-based system with a user-friendly interface, enabling self-service and streamlined workflows.
• 🔍 The new system is expected to enhance customer satisfaction, reduce operational costs, and speed up service delivery to Medicaid beneficiaries.
• 🛡️ Modernization efforts also aim to mitigate cybersecurity risks and improve data accuracy and integrity.
• 📈 The state agency's modernization is part of a broader trend towards using cloud-based platforms and services to develop multiple applications and workflows.
• 🤝 Alliances and partnerships are crucial for successful modernization, providing a diverse ecosystem of technologies and expertise to meet complex needs.
• 🚀 The modernization journey is ongoing, with plans to expand the platform to include patient portals, member enrollment, claims management, and integrated eligibility processes.

Q & A

What is the primary challenge government agencies face in modernizing their systems?

The primary challenge is dealing with aging technology platforms and other issues that hinder their ability to meet the public's needs and expectations.

Why did the state's Medicaid agency decide to modernize their systems?

The state aimed to bring a more consumer-like experience to Medicaid members and modernize their legacy systems dating back to the 1960s, which lacked the flexibility and consumer experience expected in modern services.

What was the federal government's role in the modernization of these systems?

The federal government mandated modernization to make systems less expensive, more reflective of constituent needs, and to lower risk, providing funding and incentives for the process.

Why did the state choose ServiceNow as their platform for modernization?

ServiceNow was chosen for its market-proven capabilities, its ability to bridge different systems with a common interface for end-to-end business workflows, and for being an innovative approach to modernization.

What was the role of EY in this modernization process?

EY was chosen through a competitive procurement process to demonstrate their ability to handle complex system modernizations, including not just technology but also organizational change management.

How did the modernization change the way Medicaid services were delivered?

The modernization transitioned the system from a mainframe with a blue screen to a web-based portal with personalized authentication, self-service capabilities, and a more streamlined workflow process.

What other systems or processes are expected to be modernized as part of this journey?

The state expects to modernize other modules such as patient portals, member enrollment, claims management, and integrated eligibility as part of the Medicaid process.

What tangible results does the state anticipate from this initial phase of modernization?

The state expects higher customer satisfaction, lower cost of business, faster time to resolution, more accurate data, and reduced risk to cyber attacks.

What lessons can other public sector leaders learn from this state agency's modernization efforts?

Leaders can learn the importance of using a modern, web-based platform for developing multiple applications and workflows, connecting data sources, and providing a common interface for improved service delivery.

Why are alliances important in modernization journeys like this?

Alliances are important because they create an ecosystem where different technology companies can work together, leveraging the expertise of firms like EY to make technology work successfully and assist with organizational change management.

How does this modernization align with the expectations of younger constituents?

The modernization aligns with younger constituents' expectations for the same level of convenience and accessibility they experience in consumer services, such as being able to interact with government services anytime and anywhere via phones or the web.

Outlines

00:00

😀 Modernizing Medicaid Systems for Enhanced Consumer Experience

The first paragraph discusses the challenges government agencies face in meeting the public's needs due to outdated technology platforms. The focus is on a specific State Medicaid agency's modernization journey, aiming to provide a consumer-like experience to its members. The legacy systems, dating back to the 1960s, were inflexible and did not meet modern consumer expectations. The federal government encourages modernization to reduce costs and risks, and this state chose ServiceNow as their platform for its capabilities and market reputation. The agency's decision to modernize was driven by the desire to simplify processes for both members and employees, reflecting a shift towards a more user-friendly and efficient service delivery model.

05:01

🛠️ Implementing a Modern Web-Based System for Medicaid Services

The second paragraph delves into the specifics of the modernization process. The old system, characterized by a mainframe with a blue screen and menu options, has been replaced with a web-based system that offers a personalized experience through authentication. The new system streamlines the enrollment process, checks eligibility, and facilitates workflow across different applications. The infrastructure implemented supports basic functionalities, with plans to expand into other areas such as human resource management and unique business processes. The goal is to create a modular system that can integrate with existing systems without the need for replacement, thus enhancing efficiency and reducing cyber risks.

10:01

📈 Anticipated Outcomes and Lessons for Public Sector Modernization

The final paragraph outlines the expected tangible results of the modernization, including the elimination of outdated systems, improved customer satisfaction, reduced operational costs, and expedited service delivery. It also touches on the importance of alliances in such modernization efforts, emphasizing the need for an ecosystem that includes various technology companies and partners like EY. The ability to work with different stakeholders and leverage modern platforms as a service is highlighted as a key takeaway for other public sector leaders. The modernization journey is positioned as a way to meet the expectations of a younger, tech-savvy demographic and to keep pace with the rapid advancement of technology.

Keywords

💡Modernization

Modernization in the context of the video refers to the process of updating and improving outdated technology systems to meet current and future needs. It is crucial for government agencies to modernize their systems to provide better services to the public. In the script, the state Medicaid agency's modernization journey involves moving from legacy systems dating back to the 1960s to a more flexible and consumer-friendly platform.

💡Legacy Systems

Legacy systems are older computer systems that are still functional but may lack the capabilities of newer systems. They are often based on outdated technology and can be difficult to maintain or integrate with modern tools. The video discusses the Medicaid agency's challenge of dealing with legacy systems on an IBM Mainframe, which lacked the flexibility needed for modern service delivery.

💡Consumer-like Experience

A consumer-like experience refers to the ease and convenience of interacting with a service or product as one would expect from consumer-oriented businesses. The video highlights the state's goal to bring a more consumer-like experience to Medicaid members by modernizing their systems, making services more accessible and user-friendly.

💡ServiceNow

ServiceNow is a cloud computing platform that provides services to automate enterprise operations. In the video, ServiceNow is chosen as the platform for modernizing the Medicaid agency's systems due to its capabilities in bridging different systems and providing a common interface for end-to-end business workflows.

💡EY (Ernst & Young)

EY, or Ernst & Young, is a global leader in assurance, tax, transaction, and advisory services. In the context of the video, EY is chosen to help build the new Medicaid systems on the ServiceNow platform, demonstrating their expertise in complex system modernization and organizational change management.

💡Self-Service

Self-service in the video refers to the ability of Medicaid beneficiaries to access services independently, 24/7, without the need for direct interaction with a service representative. The modernization aims to provide a self-service interface that allows members to manage their needs anytime and anywhere.

💡Federal Mandate

A federal mandate in this context is a directive from the federal government that encourages or requires certain actions to be taken. The video mentions a federal mandate that encourages modernization of systems to make them less expensive and more reflective of constituent needs, with the federal government providing funding and incentives for such modernization efforts.

💡Modular System

A modular system is designed so that components can be easily added, removed, or upgraded without affecting the entire system. The video discusses the Medicaid system becoming modular, which allows for more flexibility and easier maintenance and updates, as opposed to monolithic systems that are harder to modify.

💡Organizational Change Management

Organizational change management is the process of preparing, managing, and supporting people through organizational change. In the video, EY's role includes not only technology implementation but also helping the agency's employees and members adapt to the new systems, ensuring a smooth transition.

💡Customer Satisfaction

Customer satisfaction refers to the degree to which a product or service meets a customer's expectations. The video anticipates that modernizing the Medicaid agency's systems will lead to higher customer satisfaction by providing a more efficient and user-friendly service experience.

💡Cybersecurity

Cybersecurity in the video is mentioned in the context of reducing risk to cyber attacks by modernizing old systems. Upgrading to a more secure platform is essential to protect sensitive data and ensure the integrity of government services.

Highlights

Government agencies face challenges in meeting public needs due to aging technology platforms.

Modernization of systems is essential but also requires understanding underlying processes.

A State Medicaid agency embarked on a successful modernization journey with the help of EY.

The state aimed to provide a consumer-like experience for Medicaid members by modernizing their systems.

Legacy systems dating back to the 1960s were制约 by their lack of flexibility.

Federal government mandates and incentives are driving modernization efforts.

ServiceNow was chosen as the platform for modernization due to its market capabilities.

EY was selected for its ability to handle complex system modernization and organizational change management.

The new system allows for 24/7 self-service, enhancing accessibility for government services.

The modernization included a shift from a mainframe system to a web-based portal with personalized workflows.

The implementation aimed to improve customer satisfaction, reduce costs, and increase efficiency.

Cybersecurity risks were mitigated with the modernization of the systems.

Modern businesses expect higher customer satisfaction and lower costs, which the new system aims to deliver.

The modernization is expected to expand to other modules like patient portals and claims management.

Public sector leaders can learn from this modernization journey about the importance of a web-based approach.

Alliances are crucial for modernization efforts, providing a diverse ecosystem of expertise and technology.

The modernization aims to meet the expectations of a younger generation accustomed to immediate digital services.

Transcripts

government agencies face Relentless

daily demands to meet the Public's needs

and expectations but they routinely

struggle to do so due to aging

technology platforms and other issues

while agencies want to modernize those

systems it also requires understanding

and addressing the underlying processes

and the Art of the possible six

uccessful modernization programs then

ultimately require a combination of

business process expertise and Technical

knoow I'm y cash with scoop newsg group

and here to talk about one State

Medicaid agency's successful

modernization journey is John Wen Global

government Alliance leader

ate John thank you so much for joining

us thank you for having me Wyatt I

appreciate the opportunity to speak

about a great customer success terrific

so

let's set the stage a little what were

some of the specific issues that ey was

tasked with in addressing this

particular State's Medicaid agency's

issues first and foremost I think the

state wanted to bring a more

consumer-like experience to the members

of the Medicaid Program that they

support and so in doing so they had to

modernize their systems these are old

Legacy systems dating back to the 1960s

on a uh IBM Mainframe and Cobalt and it

didn't give them the flexibility they

wanted and you know us as uh consumers

we expect something when we're dealing

with a an organization that's providing

services so they were looking to have a

easier endtoend consumer like process

for their Medicaid beneficiaries they

call them members and for their

employees so that was important to them

also there's a mandate by the federal

government that these systems be

modernized to make them less expansive

more uh reflective of the needs of their

constituents and to lower the risk so to

take them and break them into more

discret parts uh the federal government

is actually funding a lot of this

modernization and it's not a a formal

mandate you must but it is a a you know

something that comes with a lot of

incentives for that modernization and so

this state looked at the different

options out there and they chose to go

with service now so they made the

platform the decision to go with the

service now platform because of its

capabilities it's proven in the market

and to be the first in the country to

modernize using this approach so very

Innovative approach can you uh unpack a

little bit more about what led this

state to go with service now as their

platform to modernize and and why uh ey

was chosen to build their new Medicaid

systems on that platform I I would

suggest that U you know replacing

everything is difficult uh each system

has its constituents it has uh you know

folks that are using those uh programs

and those applications successfully and

it's a big undertaking to just rip those

things out and replace them with a you

know another monolithic system so what

they why they chose service now is it's

the ability to bridge these different

systems using a common interface for an

endtoend business workflow and so that

was the they used that as the ability to

modernize aging systems but also put

this consumer uh interface on top that

allowed for

selfservice uh 247 365 self-service

anytime anywhere and that's unique to

the way government has typically been

delivering uh you know Solutions like

this so and what did they choose ey well

it was a competitive procurement and we

were able to demonstrate our ability as

a firm to handle a complex system

modernization like this so it's it's not

just technology it's also organizational

change management and how we could help

their you know their employees and uh

members actually use these systems

because they are going to be a little

bit newer but a lot of uh you know us in

the our consumer world are used to

uh you know dealing with uh

organizations via our phone the web uh

chat capability so those things are

going to be deployed here and uh we uh

submitted a winning proposal based upon

our capabilities as a firm our

credentials and helping other you know

large Global organizations modernized

complex systems like

this can you uh just Briefly summarize

what was ultimately implemented what

made it more modern compared to what

that agency had before so think about

the systems they had it was one system

on a Mainframe with a blue screen that

had menu options that were you know

essentially typing at a prompt so now uh

what you have is a web-based system that

someone can go in through a portal and

it knows who you are and what you want

to do through authentication and you

know the the enrollment process so in

that

you can choose the services that you're

interested in so in Medicaid uh

enrolling in and getting a benefit it

checks your eligibility against the

existing systems and then it moves your

workflow process across the different

applications different approvals so

underlying what we uh implemented for

them was this system for the basic

infrastructure but uh we are

implementing other things that provide

human resource uh management uh some of

their just uh unique business processes

G grievances in hearing and a number of

other things that uh give them a

platform for other modernization over

time as I noted uh you know Medicaid is

a modular system or is becoming modular

and some of those other systems are not

in the scope of our work here but

they're contemplating that so we expect

our client to leave in the market of

innovation by looking for other

opportunities to use the platform and

that common data structure that common

workflow engine and to capture data from

other systems that don't need to be

replaced but uh can uh you know be

integrated in along the way and then can

you share or talk about some of the

initial tangible results the state is is

starting to see or that at least expects

ay to deliver uh when this

initial phase is complete I think uh you

know first and foremost they're uh

getting rid of the old system that was

at risk because of uh you know the

technology that it's built on not that

mainframes won't exist in the future but

uh the the actual software was developed

long ago and was hard to hard to manage

and had a lot of risk to uh the client

but what they expect to see is things

that modern businesses expect as well

higher customer satisfaction uh lower

cost of business uh you know faster time

to resolution so a lot of these things

are really in delivering services to the

member but there are other internal

processes and so those will go faster uh

the data will be more accurate there'll

be less at risk to cyber attacks and

things like that so uh you know they're

at the beginning or let's say the middle

of the journey that we're taking with

them but they do look to have this

expand into those other modules like

patient portals member enrollment claims

management uh integrated eligibility and

things that are all part of the Medicaid

process and then lastly what lessons

would you say other public sector

leaders might take away from what this

state agency's modernization efforts U

uh has led them to and and talk a little

also about why are alliances so

important uh for these Journeys yeah I I

think that a big takeaway is that uh

using a web-based approach like this on

a modern platform you know it's a

platform as a service so it allows uh

agencies to develop multiple

applications

workflows uh you know business processes

and modernize those connecting data

sources providing that common interface

and so I think uh you see in the market

that State clients are using service now

for their it infrastructure this is

another use case into more into the

mission that can provide value and

leverage that initial investment I think

also you know building large

applications Point applications where

you're the only owner of that investment

uh can be risky and and that's a trend

that all government leaders are seeing

you know how can we build reusable

components share you know capability and

have them on common modern

infrastructure that they don't have to

necessarily procure Implement and

support so I think those are some of the

benefits and you know as we uh service a

younger constituents now now they're

expecting you know the same experience

they get when they're on their phone

buying something they want to interact

with government that way they don't

really want what I think older uh folks

like myself are used to waiting on you

know hold uh going through a call center

phone tree I want it anytime anywhere

and I want it now uh you know it's the

impatience of our of the newer

generation uh as my kids will often say

uh but uh I I think that's some of the

capabilities that uh or you know what

government should look at uh as it

relates to alliances well this is really

an ecosystem out there there's no one

size fits all so the ability to work

with different technology companies and

to use you know firms like uh ey to help

them in that Journey it's a comp complex

world and having an organization like ey

I think is important because we can help

make the technology work make it work

successfully and help an organization

with areas that they might not have

thought about like uh organizational

change management I think is always

critical when you're bringing in new

systems to a you know a stable and you

know a little older Workforce which

government typically is and uh you know

service now has been a great

organization to work with um you know

the client chose service now we have a

strong program with them and uh we're

working to innovate and modernize a

really complex world uh in government

and I I think this will be the way of

the future for a lot of uh State

organizations and agencies

well you make two great points there one

is meeting the customer where they're at

today is really important and number two

I think the pace at which technology

continues to advance more quickly than

ever before you really need kind of a

more agile and and combination of

expertise both in terms of the processes

and the technology to really help state

agencies keep up with those customer

demands so um thank you for uh

Illuminating that and and John walk

thank you so so much uh for just joining

us and sharing some of your experience

and uh helping a State Medicaid agency

really uh get moving on the path of

modernization to improve customer

service so thank you so much for being

with us thank you Wyatt for having me