Selecting a Health and Human Services Platform Solution

Selecting a Health and Human Services Platform Solution

Selecting a Health and Human Services Platform Solution

Selecting a Health and Human Services Platform Solution

Executive summary

Executive summary

Executive summary

Executive summary

Explore how a platform-first approach is beneficial for social program management.

Explore how a platform-first approach is beneficial for social program management.

2 min read
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What are the key reasons agencies are taking a platform-first approach?

What are the key reasons agencies are taking a platform-first approach?

What are the key reasons agencies are taking a platform-first approach?

What are the key reasons agencies are taking a platform-first approach?

Discover the requirements leading agencies to pursue platforms over custom solutions.

Discover the requirements leading agencies to pursue platforms over custom solutions.

3 min read
02

Why have a platform specific to Health and Human Services?

Why have a platform specific to Health and Human Services?

Why have a platform specific to Health and Human Services?

Why have a platform specific to Health and Human Services?

See the benefits of HHS-specific platforms compared to generic platforms.

See the benefits of HHS-specific platforms compared to generic platforms.

3 min read
03

Why choose IBM® Social Program Management?

Why choose IBM® Social Program Management?

Why choose IBM® Social Program Management?

Why choose IBM® Social Program Management?

Learn how IBM® Social Program Management could benefit your organization.

Learn how IBM® Social Program Management could benefit your organization.

5 min read
04

Conclusion

Conclusion

Conclusion

Conclusion

An HHS-specific platform can lead to more efficient management of social programs.

An HHS-specific platform can lead to more efficient management of social programs.

1 min read
05

Selecting a Health and Human Services Platform Solution

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2 min read

Executive summary


With Health and Human Services (HHS) agencies juggling high administrative burdens, changing federal and state regulations, knowledge loss from the retirement of long-term public servants and shifting budget constraints, the need to modernize case management has become critical. We will be examining this shift in thinking by exploring three questions:

1

What are the key reasons agencies are taking a platform-first approach?

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Why have a platform specific to Health and Human Services?

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Why choose the IBM® Social Program Management (SPM) platform?

HHS agencies have many options to consider when selecting a solution to drive modernization and increase efficiencies. This motivation is leading agencies to adopt a platform-first approach.

In general, a platform-first approach means that agencies are looking for technology to manage their social programs that is maintained by a third-party, which saves them from the burden of having to manage their own in-house infrastructure for training, support and programming customizations. But there have been numerous interpretations of the term. As a result, rather than simplifying the conversation, placing so much emphasis on a platform has created some confusion.

While many platform vendors might claim to meet the requirements that are pushing HHS agencies toward a platform-first approach, a platform built specifically for the HHS domain can offer a distinct advantage over platforms that serve many different domains. For multi-domain platform solutions, creating HHS components, or even integrating components from different vendors, can require extensive customization as well as complex and costly integration projects. The lack of industry expertise in a core platform offering can lead to ongoing implementation and maintenance headaches for government agencies. If a platform is not built specifically for HHS, the agency will have to build it themselves (which is expensive and hard) or it will have to accept a poorer user experience for caseworkers and lower operational efficiency (which increases costs and diminishes the citizen experience). In contrast, an industry-specific HHS platform offers domain-specific features and functionality that will improve overall outcomes.

The IBM SPM platform meets all of the requirements that are driving HHS agencies to select platform solutions in their procurements and has additional capabilities that differentiates it from platforms built for other domains. IBM SPM has been infused with deep industry experience in best practices for social programs, which makes it a proven solution for the HHS market.

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3 min read

What are the key reasons agencies are taking a platform-first approach?


To avoid confusion, agencies may wish to avoid saying that they’re seeking a platform (either a specific platform or using the term generally) and start their search for better technology by articulating what the system should do and who it will serve.

A man smilling

In our experience, this exercise reveals a set of common requirements that are driving HHS agencies towards a platform-first approach:

Easy configuration and customization to deliver value quickly
HHS agencies have been aware for a long time that having a solution that fits their requirements well will reduce the risks associated with custom-built projects and deliver value more quickly. Platform solutions aim to offer configurable solutions, which reduce the need for custom extensions to be added. However, these configurations still create a custom solution that is not supported by the platform vendor. Generic platform vendors encourage minimal configuration so the client may easily upgrade but the generic platform does not support the unique needs of the HHS enterprise without configuration. HHS platform solutions make it possible for future upgrades of the platform to be seamless even with the customizations.

A supported development framework to control project costs
A custom-built solution built on a generic platform or even one sourced from many different vendors, implies that HHS agencies will have to develop their own system documentation and training materials, provide their own technical support and create their own user communities. HHS platform solutions have these services built in as well as others, such as services for installing new products, installing product updates and performing migrations for major software releases.

Outsourced IT operations for budget certainty
HHS agencies are under pressure to provide better outcomes, yet budgets are shrinking. They’re aware that cloud and emerging cloud technologies offer opportunities for them to optimize both technically and operationally as well as deliver budget transparency and certainty. Platform solutions that are cloud-hosted, or deployed to cloud, allow agencies to outsource the complex management of hardware, software provisioning and operations, and these solutions allow them to focus on creating business value. Portability across clouds can offer an agency multiple choices for cloud services and helps them to avoid lock-in to a specific cloud offering.

Incremental modernization and reduced technical risk
Recently, some agencies have expressed a need for modular solutions. The underlying requirements for modularity include support for incremental modernization, avoiding vendor lock-in, and reducing technical risk. Platform solutions can support these requirements by providing feature components, strong API integration strategies and upgrading management infrastructure. To reduce technical risk, platforms that wrap around existing legacy systems to modernize the user interface before attempting to modernize the backend technology should be avoided.

A roadmap to a future-proof solution
HHS agencies need to know that the solution they buy will meet their requirements on day one and will continue to deliver value as well as respond to changing market needs. A strong future vision and roadmap that factors in both evolving technology and customer requirements are key to delivering constant improvements.

Assessing solution providers against these requirements is a good start. This approach may reveal a superset of potentially suitable vendors, including both generic customer relationship management (CRM) solutions that are attempting to expand horizontally into the HHS domain as well as HHS platform solutions that were built specifically for HHS from the ground up. However, there are several critical differences between platforms that are built specifically for HHS and those that aren’t.

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3 min read

Why have a platform specific to Health and Human Services?


There are important ways in which a platform built specifically for the Health and Human Services (HHS) domain can offer a distinct advantage over those that serve many different domains. Because an HHS-specific platform was designed with HHS caseworkers in mind, it’s a system that’s more intuitive to use, which also makes it a more efficient system and a better functional fit requires fewer customizations at the project level.

Below, we list five beneficial capabilities that an HHS platform can offer HHS agencies compared to generic platforms.

Family-centric


Two women talking

HHS platform

Caseworkers capture complex data that helps them assist individuals and families in need.

The user interfaces and underlying data models of HHS platforms are designed from the ground up for underlying HHS processes, such as benefits delivery, family unit services and adoption.

Generic platform

The user interfaces and data models are intended to support the relationship between a customer and a salesperson, not a family in crisis and a caseworker.

Extensions to the data model – including those required to drive analytics – must be made for individual projects and are not supported as agencies perform regular updates, which requires them to continue to manage extensions well past the life of a contract.

If extensions are made through configuration and not supported at the database level, the ability to report on key elements and the interdependency between key elements is put at risk.

Business processes


A group of people in a meeting

HHS platform

The system is built with functions that are specific to HHS as well as built-in configuration and extension points for each stage of a project when diverging requirements are commonly needed.

Domain-specific features (such as intake, verifications and appeals) and content (such as rules, workflows, and reports).

Generic platform

Horizontal, cross-domain platforms tailored to the HHS market either don’t deliver these features at all – which increases the amount of customization that must be done – or have them added to a system built for a different purpose.

The resulting user experiences can be clunky since processes are stretched to fit HHS use cases and may lead to lower overall operational efficiencies.

Financial accuracy


A man wearing a suit using is cellphone

HHS platform

An HHS-focused system is built to handle complex legal and financial requirements.

There is a reduced amount of custom development required to support these unique industry processes.

Generic platform

Multi-domain platforms often rely on a rules engine designed to support point-in-time decisions.

Do not have functionality built-in that supports benefit calculation including over-payments, under payments and effective dating for benefits.

There is increased risk and difficulty in paying people accurately (especially for recurring benefits) as well as explaining the reasons for an eligibility decision.

Data sharing

A company photo

HHS platform

Agencies can take an Integrated Service Delivery Model (ISDM) approach to service delivery, which means multiple agencies can work together to collaborate and coordinate their support and services for clients, which could lead to better outcomes.

Data is captured once and used across almost all programs the client participates in.

A common view of the client is available highlighting their involvement with multiple programs.

Generic platform

Customization is required to collaborate with other HHS agencies or programs

A non-ISDM approach might be used.

Data security

A woman wotking on her computer

HHS platform

Agency requirements to protect unauthorized access to data are supported with features, such as sensitivity-based, role-based and location-based security.

Generic platform

There is a lack of pre-defined industry roles, which creates greater risk for mis-aligning access with a role and for providing improper access to key cases, elements of a case or case routing.

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5 min read

Why choose IBM® Social Program Management?

A man sitting on the floor talking on the cellphone working and his little child sit next to him

The IBM® Social Program Management (SPM) platform meets all the requirements driving HHS agencies to select platform solutions in their procurements and has the additional capabilities brought by HHS-specific platforms, which differentiate them from platforms built for other domains. On top of this, IBM SPM is backed by a depth of social program experience, making it a proven solution for the HHS market.

Find out how →

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1 min read

Conclusion


Health and Human Services (HHS) agencies that are exploring ways to update their systems and that are considering a platform solution should focus on identifying what the system should do and which users it will serve. Determining requirements early in the process will help agencies narrow down a list of suitable vendors that includes both generic, horizontal customer relationship management (CRM) platforms as well as HHS-specific platforms, which can then be narrowed down further.

There is a perception in the market that standardizing a generic horizontal CRM platform or platform-as-a-service will be a successful foundation for multiple HHS programs. However, there are key components of these cross-domain platforms that are missing. This results in extensive customization and a costly project for the state that may not deliver the expected results. Platforms built from the ground up specifically for the HHS domain offer unique advantages over platforms attempting to expand horizontally into the HHS domain that serve multiple domains.

If a platform is not built specifically for HHS, the agency will have to build it themselves (which is expensive and hard) or it will have to accept a poor caseworker experience and lower operational efficiency (which increases costs and diminishes the citizen experience). In contrast, an industry-specific HHS platform offers domain-specific features and functionality that will improve overall outcomes.

The IBM SPM platform meets all the requirements driving HHS agencies to select platform solutions in their procurements and has the capabilities of HHS-specific platforms. Built with deep industry experience in the market as well as the input of experts and experienced caseworkers, it is a proven HHS solution.