Deloitte Consulting LLP

With state healthcare agencies facing new IT guidelines for Medicaid systems, Deloitte Consulting LLP sought a proven technology leader to help develop an innovative enterprise solution.

Deloitte teamed with IBM to create the MES HealthInteractive Platform, an offering designed to tie Medicaid IT modules together in a flexible cloud-based architecture.
 

For decades, state healthcare programs relied on large legacy Medicaid Management Information Systems (MMIS) to support core functions. To address the growing cost and complexity involved in maintaining and updating these platforms, the Centers for Medicare and Medicaid Services (CMS) established guidelines to shift programs toward a new approach to IT—one focused on modular, interoperable solutions.

With more than 30 years as a consultant to state healthcare agencies and extensive experience as a systems integrator, Deloitte was uniquely qualified to help organizations meet the challenges of modernization. Offering the insight, industry knowledge and breadth of integration skills required to deliver a highly effective new Medicaid enterprise solution, the company sought a proven technology leader to help develop the platform. 

IBM offered the cohesive suite of products Deloitte was looking for, including powerful cloud technology. “Having a solution that could scale massively was very important,” says Van Spaulding, Senior Solution Architect for Deloitte. “Plus, we wanted a hybrid hosting model where we could offer a software as a service solution to our clients, but still maintain single-tenant architecture that wouldn’t mix client data. We’re able to do this with IBM Cloud as our foundation.”

Deloitte teamed with IBM to develop the MES HealthInteractive Platform, an offering designed to tie Medicaid IT modules together in a flexible cloud-based architecture. Running on a core service bus comprising IBM MQ, IBM Integration Bus and IBM WebSphere® Service Registry and Repository software, the solution uses IBM WebSphere Application Server software as its front-end portal application and IBM Operational Decision Manager and IBM Business Process Manager software for process automation.

The VMware Cloud Foundation on IBM Cloud platform provides firewall services, virtual SAN components and other virtual resources for rapid deployment of the MES solution. “When we provision an environment, we request the necessary components,” says Spaulding. “The model is really infrastructure as code—with VMware Cloud Foundation, we essentially have a virtualized data center that allows us to quickly and dynamically adapt but also have the layered security controls we need.” 

The collaboration between Deloitte and IBM resulted in an innovative solution for helping state healthcare agencies align with CMS guidelines and adopt a more modular approach to enterprise IT. With MES architecture in place, programs can keep their technology up-to-date with far less effort and expense, replacing individual modules as needed instead of revamping an entire enterprise system. 

“The beauty of MES is that if an agency ends up not liking the functionality of a particular provider module, the organization can pull it and easily deploy a new module without disrupting what’s going on in claims processing or other modules that have been implemented,” says Brian Erdahl, Principal and Market Offering Leader for Deloitte.

The MES platform also helps programs work more effectively across disparate organizational areas. “Agencies can exchange data much more readily between modules—it isn’t locked up,” says Erdahl. “Access to information is easier and quicker. Users can perform analytics or operational reporting tasks within their Medicaid programs in a matter of hours versus monthly batch extracts.”

A subsidiary of Deloitte Touche Tohmatsu Ltd., Deloitte Consulting LLP (link resides outside of ibm.com) is organized into three primary service areas: Human Capital, Strategy and Operations, and Technology. The consulting firm is headquartered in New York, maintains 110 locations in the US and employs approximately 45,000 people working across more than 20 industry sectors.