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The transcript discusses the modernization journey of a state Medicaid agency, facing challenges with outdated technology.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.