John Joaquin, EY | Modernizing a State Medicaid Agency’s Technology Platforms
Summary
TLDRThe transcript discusses the modernization journey of a state Medicaid agency, facing challenges with outdated technology.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
😀 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.
🛠️ 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.
📈 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.
Mindmap
Keywords
💡Modernization
💡Legacy Systems
💡Consumer-like Experience
💡ServiceNow
💡EY (Ernst & Young)
💡Self-Service
💡Federal Mandate
💡Modular System
💡Organizational Change Management
💡Customer Satisfaction
💡Cybersecurity
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
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