Health Care System Digital Transformation
Medicaid Eligibility System Modernization (MAGI Medicaid)
A part of the Health Care System, their department for children with special needs is a Medicaid managed care organization (MCO) providing health coverage to chronically ill children and young adults in the state.
With the renewal of their MCO contract with the state in 2022, the department for children with special needs identified a series of IT and data exchange capabilities to develop as part of their contract. The department engaged Agilian to help create and implement a comprehensive end-to-end Digital Transformation Plan to completely transform the experiences of employees, enrollees, and providers who interact with the department. Agilian’s development work at the department includes cloud integration architecture, cloud portal framework, single sign-on, data warehouse, data analytics, service-oriented architecture (SOA) middleware application program interface (API), open source Oauth-based Identity Provider System, and Fast Healthcare Interoperability Resources (FHIR) compliant APIs.
To ensure the success of the Digital Transformation Plan from both a technical and business standpoint, Agilian also provides Value Delivery Office (VDO) and organizational change management (OCM) services. The VDO supports the strategic management and technical delivery of the IT initiatives included in the Digital Transformation Plan, and our OCM team leads the process of communicating, educating, motivating, and preparing those impacted by the digital transformation and enterprise integration at every step of the way.
Agilian has worked over the past year to understand the department’s current technology landscape and define a bold, but feasible, cloud and health information technology roadmap to transform the department’s digital and application environments to better serve the staff, stakeholders, providers, and members of the MCO.
Result: Through Agilian’s work, the Health Care System was able to prioritize and plan a series of digital transformation initiatives and projects to not only meet their contractual and regulatory requirements, but also completely transform the experiences of employees, enrollees, and providers who interact with the department. By reimagining the way information flows to and from all stakeholders, the department will:
Create a united, person-centric experience for enrollees, care managers (CMs), and providers;
Distribute timely, family-centered, outcome-focused data and information to and from the care team and throughout the organization;
Operationalize predictive analytics to ensure that all enrollees benefit from the earliest possible health care interventions necessary;
Enable data interoperability between the department and other educational, health, community, and social service organizations serving enrollees; and
Be better positioned to respond to anticipated and unanticipated changes in the healthcare regulatory landscape.