By Ernie Connon
“Great moments are born from great opportunity.”
So, said Herb Brooks, the legendary coach of the 1980 U.S. Men’s Olympic hockey team before its miraculous win over the Soviet Union in Lake Placid, N.Y.
Today, Health and Human Services Departments in every state face a “great opportunity” to reshape how they deliver vital health and social services to citizens.
While it would be easy to look at this moment of an evolving healthcare and social services environment as simply a mandate to change , forward-looking leaders see opportunities for bold transformations in how they manage and deliver programs such as Medicaid. These leaders maximize existing technology investments, empower caseworkers to focus more on individuals and families, and evolve operations to meet tomorrow’s challenges.
In many states, the reality surrounding these social services programs are legacy systems with information silos and data residing in multiple locations. Imagine the impact on the citizen who has had a life-changing event and wants to simply learn what benefits he or she is eligible for. Due to system complexities and information silos, it is estimated that $65 billion in benefits for low income families goes unclaimed each year.
Needless to say, that creates a stressful situation and one in which a maze of forms and contact information can be quite intimidating. And imagine the challenge for the caseworker who lacks a single full-picture view of an individual’s or family’s situation. And then multiply this by each and every case worker.
“We are transforming an IT infrastructure that is composed of more than 30 discrete system silos in an aging architecture,” said Dick Wyatt, chief information officer for the Arkansas Department of Human Services (DHS).
The Arkansas DHS has more than 7,500 employees working throughout the state and in 85 county offices. Serving more than 1.4 million people each year, including infants, children, adults, people with disabilities and the elderly, the agency also promotes volunteerism, funds community programs, regulates nursing homes, licenses daycares and finds foster children permanent families.
Working with an IBM Smarter Cities solution, Arkansas DHS is bringing one view of their clients in one application, providing citizens with a single point of access in determining eligibility for programs they may not be aware of. In turn, DHS can react in a more timely and efficient fashion.
For John Supra, deputy director & chief information officer for the South Carolina Department of Health & Human Services (SCDHHS), the choice focused on citizen-centric services. “Our updated Medicaid eligibility system will make it easier for all South Carolinians to access the State’s programs,” said John Supra, deputy director & chief information officer for SCDHHS. “Our current manual paper-driven approach limits flexibility in our processes and impacts speed and consistency. We expect the new system to provide us a platform to improve our eligibility performance and be able to more quickly and cost-effectively respond to future changes to the Medicaid programs.”
SCDHHS provides healthcare benefits to more than 1.1 million South Carolinians. The agency’s transformation with an IBM Smarter Cities solution will help the state manage its Big Data challenges in migrating from a largely paper-based approach to a more open, automated platform to manage eligibility requirements and also integrate with a federal health insurance marketplace.
Arkansas and South Carolina follow the example of Utah. With IBM, the state improved accuracy by integrating six systems to show eligibility for 2,000 programs. They saw an increase of 50 percent more citizens served without additional costs to taxpayers — by reducing errors and simplifying process.
These states are relying on IBM Curam software, part of IBM’s Smarter Cities portfolio that focuses on helping cities and governments do more with less and/or existing resources. These capabilities help governments meet their objectives and, more importantly, make access to services easier, improving care and quality of life for their citizens.