Upgrading a complex eligibility and enrollment environment

Challenge

A state Medicaid agency needed to maintain continuity of services for its citizens during the following initiatives: transitioning the maintenance and operations of their existing eligibility system to a new vendor, simultaneously implementing their new Medicaid Management Information System (MMIS), and developing a Request for Proposals (RFP) for a new integrated eligibility solution.

Solution

BerryDunn’s experts:

• Facilitated agreements between multiple stakeholders and contractors on risk mitigation and issue resolution, during and after the transition.
• Developed an RFP that provided an innovative, long-term approach to maturing their Medicaid Enterprise within the context of business and procurement realities.
• Provided state staff time to focus on their MMIS implementation and integrated eligibility system RFP.

Outcome

The client successfully transitioned their existing eligibility system on a tight deadline without compromising quality of service. The new M&O contract provides the state flexibility to take a new approach in the future of their Medicaid Enterprise.