277K applications processed
5M in savings
Need for change
In 2009 when the Affordable Care Act was passed, Colorado elected to be one of 17 states to create their own health insurance marketplace instead of using the systems provided by the Federal government. They also expanded Medicaid coverage. To ensure their citizens had access to these expanded health care benefits as soon as they came into effect on October 1, 2013, the State of Colorado had 6 months to build the new integrated system required to process applications online.
Building a connected government
Medicaid eligibility is based on a number of qualifications, including income, citizenship, and identity. In the past, eligibility could take up to 45 days to determine. Citizens could apply online, but county offices had to manually re-enter the application information in a separate database to determine eligibility. Disconnected systems added manual work that meant each application would then take approximately 1 ½ hours to process, as caseworkers verified and processed each case.
The expectations of today’s citizens have evolved significantly over the last 10 -15 years. They now live in a 24/7 world, where they expect all of the services they consume (i.e. paying a ticket, obtaining a license or applying for Medicaid) to be readily available, easy to find and easy to use. The State of Colorado needed to deploy a system that met their citizens’ ever-growing expectations, while still meeting their tight implementation timeframe.
Colorado transitioned the citizen benefits management system, Colorado PEAK, onto Salesforce.com’s Force platform, where citizens were able to apply online for public assistance benefits. State of Colorado decided to extend PEAK and use it as the platform for determining real-time Medicaid eligibility, since this would allow them to meet their tight deadline and provide the customer experience expected by their citizens.
Delivering a seamless experience for citizens required integrating PEAK with a number of systems including systems owned by the Social Security Administration and the federal government, as well as several internal state systems. To solve this problem they knew they needed a robust, hybrid integration platform that could bridge cloud and on-premises systems in a scalable and secure environment.
Healthcare access to all
MuleSoft’s Anypoint Platform was chosen as the integration backbone to enable communication with other critical systems. Using the Salesforce connector, developers easily connected PEAK with the other key systems required to support the Medicaid application and determination process. This developer-first experience, combining out-of-the-box functionality, reusable integration templates and graphical data mapping capability meant developers could be productive almost immediately.
Time to value was critical for Colorado and MuleSoft was able to deliver. The extended PEAK platform was launched on-time and more than 277,000 applications were processed by the system, enabling Colorado citizens to receive health care benefits during the first 6 months of health care reform.
Antoinette Taranto, Chief Customer Officer said, “Before MuleSoft and Salesforce, we were processing 30,000 applications per month with a $30 million annual personnel budget. Now, we are able to process 60,000 applications per month with the same $30 million annual budget. Prior to modernizing PEAK, we would have had to double our staff to accomplish this.”
In addition, Medicaid applications can now be processed in a single session and citizens can find out their eligibility in real time. Initially, the State of Colorado anticipated they would have to be able to provide 20% real-time eligibility for citizens, but such is the completeness of the solution, in the first 6 months they have been able to reach a nation-leading 70%. Michael Brown, Deputy CTO, estimates this amounts to savings of $5 million in employee time thus far.
More than that, PEAK has empowered citizens by transforming Colorado into a more transparent government and providing the information that citizens need. As a thought leader in the public sector, the State of Colorado has received a number of innovation awards for their work, including being awarded the Computerworld Laureate award in two consecutive years.
“Colorado citizen lives are better with a transparent government built on systems of integration. MuleSoft’s Anypoint Platform has been instrumental in the success of the healthcare exchange,” said Brown.
The overall vision for the State of Colorado is to deliver a quality customer journey for their citizens that provides them a single point of contact to find and consume all of the data and service that they need. In order to execute on this vision, they plan to expand their connected health insurance marketplace model and build a broader citizen engagement platform, leveraging the integration and cloud capabilities already deployed with PEAK.
As Brown said, “We are a cloud first, mobile first and API first state. We are constantly looking for opportunities where we can use technology to provide enterprise-level services to our citizens. MuleSoft’s Anypoint Platform and Salesforce enable us to make that vision a reality.”