Implementing Paperless Medicaid Operations
The Electronic Document Management (EDM) project for a State’s Medicaid program began with the goal of converting the majority of statewide operations from paper-based to electronic processing. The intent was two-fold, both to improve operational effectiveness and to improve support for Medicaid Participants. The Ripples Group guided the agency from concept to pilot to statewide implementation.
The engagement started with an initial assessment phase leading to the design of the pilot site, which in turn led to statewide roll-out over 18 months. Each step required rigorous review of operational capacity for projecting and executing realignment of staff and technology resources. State Medicaid now processes 98% of incoming documents via electronic imaging. The scalable design now supports scanning for many large-scale state agencies running through a centralized scanning facility.
The Ripples team focused on developing a comprehensive solution, ensuring that all types of documents had a clear workflow from receiving through the staff viewing the documents at their workstations. The initial assessment and pilot design were carried out by a Ripples team working closely with the pilot Medicaid Enrollment Center (MEC) and the newly named Electronic Document Management Center (EDMC). Ripples developed “as-is and “to-be” workflows and worked closely with IT partners to ensure that the development addressed business needs adequately. When the pilot started, the Ripples team was on the ground, supporting the implementation. In parallel, Ripples led the assessment of the other MECs and the Central Processing Unit (CPU), developing detailed plans to prepare these operations for statewide EDM.
After both pilot and statewide roll-out, Ripples continued in its quality assurance roll and carried out an assessment of the EDM implementation at each Medicaid site. These assessments were conducted at a detailed operational level, addressing overall effectiveness and individual performance variations.
Throughout the EDM transition, Ripples led many aspects of the project and supported others. The Ripples team collaborated closely with IT resources and field operations, gaining trust and respect. From weekly meetings—daily at the beginning of the pilot—to focus groups and in-depth data analysis, from hands-on support of personnel to advising the head of operations, Ripples has been integral to the success of EDM.
Two Ripples consultants, Atilla Habip and Tom Innis, received certificates of recognition from the state agency for their contributions to the project’s success. In fact, on the four occasions when Medicaid faced a dramatic change in the last decade, the executive team has consistently turned to The Ripples Group for assistance with business processes, staffing analysis, technology feasibility studies, and project management.