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Modernizing the Medicaid experience

How can states and providers use modularity to modernize? Dustin Haisler at GovTech.com interviews Optum product leaders for insights.

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The pressure’s on for states to provide a more modern experience

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Streamline Medicaid provider management

If you work for a state Medicaid agency, you know this: There’s great pressure to address aging systems and provide a modern experience to stakeholders. And for many states, the solution lies in modularity.

Why? Because modularity is an effective strategy to incrementally modernize without disrupting the entire Medicaid operation.

How does modularity apply to provider management?

A recent episode of GovTech.com's "In Case You Missed It" (ICYMI) series provides some answers. John Campbell, senior product manager for Provider Solutions at Optum State Government Solutions, and Stacia Nowinski-Castro, solutions architect for Optum State Government Solutions, discuss what to consider when taking a modular approach to provider management.

Leveraging their collective experience in state government, business solution architecture, provider enrollment and product assessment, they share important trends, insights and recommendations.

The discussion offers nine key takeaways for creating the modern provider experience you’re envisioning:

  1. Preparation is essential to a successful implementation, so think about which modules to develop first, and have fundamental components in place first. The system integration layer is often a good place to start.
  2. Gather feedback from providers, understand their pain points and build the module in response to these learnings.
  3. Apply human-centered design so the solution is intuitive to how humans think and work.
  4. Take advantage of the cloud so you can scale up and down as demand dictates. Consider how to rearchitect your current operating environment to make the migration efficient.
  5. Focus on security to eliminate potential threats presented by migrating to the cloud.
  6. Consider the interoperability that will need to occur among multiple vendors and partners as more and more modules make up the Medicaid enterprise.
  7. Partner with vendors in a way that is transparent, being honest about your vision, goals and concerns. And ask for their feedback throughout the partnership.
  8. Get subject matter expert buy-in early and often to ensure the project’s success.
  9. Test, test, test to identify any system shortcomings.

Ready to learn more? Listen to the full conversation for additional insights.

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