How Deloitte is helping build a better Medicaid Enterprise System

By | 3 minute read | August 27, 2020

HealthInteractive, a cloud-based solution connecting MES modules

Every day, Medicaid serves the medical needs of 97 million low-income Americans. Without it, many would be unable to afford basic healthcare services. It’s up to each state to ensure that it runs smoothly, and they’ve traditionally used Medicaid Management Information Systems (MMIS) to do that. Built on aging technologies, these antiquated systems are inflexible, costly to maintain, and can lead to more downtime, and increased risk of sensitive data exposure.

In 2015, the Centers for Medicare & Medicaid Services incentivized states to migrate their legacy systems to modular, interoperable Medicaid Enterprise Systems (MES) that use commercial off-the-shelf and Software-as-a-Service products. It was an opportunity to abandon the monolithic model, in favor of a modular one. This allows states to rapidly deploy separate modules from different third-party providers to handle specific jobs, rather than relying on a single inflexible program that tried to do everything.

Deloitte also saw an opportunity to help build a better MES. We created HealthInteractive, a cloud-based solution connecting MES modules to facilitate timely data exchange, high processing performance and transparent visibility into Medicaid operations. It’s also the winner of an IBM Beacon Award for Outstanding Service or Solution Built and Delivered on the IBM Cloud.

Making a difference
In one U.S. state, the statewide public health department was in the process of replacing its 35-year-old legacy MMIS. The skills to update the mainframe-based system were becoming harder to find and the vast, sprawling program was monolithic, making it difficult to change any single feature without affecting everything else.

This isn’t an uncommon challenge and it makes new functionality almost impossible to implement. So, as the state modernized its programs enterprise, the team selected Deloitte as the systems integrator and HealthInteractive as the base for their integration platform.

Deloitte was well-positioned to deliver HealthInteractive, having worked in the public sector for more than 50 years and implemented the solution in several other states. This platform would be the key integration point for software from dozens of other vendors, as well as the foundation for a mission-critical public health system. Poor performance or data loss could cause problems for citizens who depended on state-funded health services.

Choosing the right technology
While there are lots of options available, we wanted reliable, low-risk technology. And above all else, we wanted to be good custodians for this valuable information. That led us to select IBM for the integration technology needed to bring HealthInteractive to life.

The entirety of IBM’s portfolio means that we can accomplish almost everything we need with a single vendor. Plus, Deloitte has a relationship spanning over two decades with IBM, so we’re familiar with the ins and outs of its technology offerings.

HealthInteractive is hosted in a commercial or FedRAMP cloud environment and delivered as a managed service. By running on cloud technology, Deloitte can provision new computing resources to get services up and running quickly without waiting for requisitioned hardware. Cloud-based APIs also make it easier to integrate other vendors’ systems with the MES.

Bottom line: When you’re providing critical services for a critical audience, scalability and reliability are huge factors. We get that by working with IBM.

Powering adaptable healthcare
HealthInteractive supports healthcare administrators and citizens through several plug-in products, including a population health management module. Successful integration results in a cohesive, efficient enterprise with standards-based data exchange, high throughput and processing performance, and transparent visibility into MES operations. Adding this as a module to our platform is much faster than it would have been under the old monolithic system. In that scenario, you would have had to rebuild the old program with this new capability in it to get the same functionality.

Deloitte is helping several other states plan, design and implement HealthInteractive in support of their MES modernization programs. Our end goal? To help states improve access to healthcare and drive better outcomes for Medicaid enrollees and program administrators.

HealthInteractive is the latest in a string of joint achievements for Deloitte and IBM. Learn more about our relationship.

Interested in learning more? Watch: