Nick: Hello Rick and welcome.
Rick: Hi Nick.
Nick: Rick, so tell us, what’s next for health and human services organizations?
Rick: HHS organizations are going to become more resilient. They will re-think traditional processes, program administration approaches, and use new digital technologies. There are 6 areas that will be the focus for the coming year:
- Unwinding of pandemic processes
- Accelerated transition to the cloud
- Permanent remote work
- Focus on behavioral health
- Accelerated transformation in Medicaid; Modernizing MMIS
- Integration of various health and human services programs – SNAP, TANF, Medicaid etc.
Nick: Let’s dive into each of these areas. What did you mean by unwinding of pandemic processes?
Rick: It is a term being adopted by the CMS. There were a lot of processes that were put in place during the pandemic. Some programs as well. These will have to be reversed. For example, there was Pandemic Food or Pandemic SNAP assistance that will no longer exist and agencies will need to remove these capabilities from their systems. There was a requirement to make sure people had all their Medicaid coverage throughout the pandemic so agencies suppressed renewals. Agencies will need to go back and assess. It’ll be a strain on the systems. Agencies can use tools like RPA (Robotic Process Automation) to ease the transition back to normal operations.
Nick: How about cloud? Why would agencies transition to cloud and how will it help?
Rick: Public sector and health and human services have historically been very resistant to use the cloud. The pandemic has shown a need to scale quickly. The cloud fulfilled that need. And now that they have been forced to use the cloud, they feel more comfortable. There’ll be a huge transition to the cloud. It’ll accelerate starting this year but things have been in the process for a while. For example, in California, they’ve been migrating from four different eligibility systems in the state to one called CalSAWS which is cloud-based. Where the big players go, small players follow. So, I see everyone moving to the cloud over the next several years.
Nick: My understanding is that Cloud-based systems will also aid in permanent remote work – the next in your list?
Rick: Historically caseworkers have worked together and been inside the office for security concerns and other things. Pandemic changed all that. People went home and they were productive. Agencies were able to do things through VOIP phones. They had scanned apps if they needed to go through and adjudicate eligibility determination. Cloud was a critical part of these capabilities. It allowed agencies to scale up and provide capabilities quickly. In some cases, agencies were turning things around in two weeks that would have taken a year and half in the pre-pandemic era. So, cloud was the tool that made it happen.
Nick: Let’s talk about the next trend - behavioral health assistance. What is it and how will agencies focus on it?
Rick: The Pandemic has shown that a lot of people have needs other than just basic medical care and food assistance. There has been a lot of stress and mental anxiety. States are focusing on behavioral health in trying to prevent problems that become medical issues. They are doing things like evidence-based treatment. They are trying to assess programs in behavioral health that will keep people from visiting the emergency department, which is a very expensive way of getting primary care. So, we’ll see more focus on behavioral health. We’ll see new systems being built, probably cloud-based, and a greater use of analytics.
Nick: This leads me to the Medicaid program which also witnessed increased enrollment and caseload during the pandemic. Agencies that had started building their Medicaid Enterprise Systems fared much better. How do you see agencies’ MES initiatives evolve in 2022?
Rick: There were probably half-a-dozen states that started the Medicaid Enterprise System path before the pandemic. The focus for Medicaid Enterprise System is to modularize. Historically, these systems have been monolithic, one big application and very expensive – half a million to a billion dollars. If a system of this size fails, it becomes very expensive to fix. So, the idea is to take modules, based on functionality like claims payment, third party liability, pharmacy management etc., and build them incrementally. That way if there’s a problem and things take longer than expected, it’ll be at a smaller scale. So, you can solve the problem and move on and avoid the situation where the system’s too big to fail.
Nick: Let’s talk about the final trend for our discussion today – the integration of health and human services programs – something that agencies have always wanted but struggled to do. What will be different in 2022?
Rick: The pandemic has been a great driver of this. There has always been a talk, even going back to the ACA days, about no wrong door and a person-centric approach. But the pandemic has shown that you really need to focus on people holistically. It’s not just their food benefits, not just their cash benefits, not just their medical benefits. It’s about taking the whole lifetime of the beneficiary, from a child welfare system all the way through adulthood and even into old age in Medicare. I think you will see a lot of work with program integration and I think things like cloud and ability to move data quickly and ability to aggregate data will enable this.
Nick: So, what is Infosys Public Services doing to help HHS agencies navigate these nexts?
Rick: We have several point solutions to help do these things. We have robotic process automation (RPA). It can look up claims, look up eligibility, and basically automate a process and leverage your investment in case workers.
We have a software solution for that and a whole practice around RPA that uses all the tools in the marketplace. You see a lot of agencies turning towards this tool to try and get more out of their existing systems and automate because they can’t really hire enough caseworkers to get the job done.
Next, we have a whole set of solutions and consulting around cloud migration and enablement called Cobalt . We have done a lot of cloud work for several companies and developed several accelerators that are relevant for state health and human services agencies.
We have a concept called iMESIA. It’s our Medicaid Enterprise Systems integration architecture. It’s a design pattern for creating a MES. It’s modular, standards based, and can also extend to other programs outside the Medicaid space.
The Infosys Live Enterprise Suite enables the remote worker to do the most and make them feel part of the organization. We can use this to accelerate health and human services agencies’ ability to enable remote work and improve engagement.
IHIP, our Infosys Health Insights Platform , is an artificial intelligence platform. Beyond just aggregating data and ingestion which many solutions do these days, we’ve applied AI to AI. Our automation ability to do modeling through AI gets rid of the need to bring a lot of data scientists and other people who are scarce resources. It accelerates organization’s ability to do data aggregation and get the insights.
We have also established a dedicated Rapid Application Development practice. We are seeing a lot of low-code/no-code solutions, especially during the pandemic where agencies had to bring capabilities very quickly, in a couple of weeks. So, business users can go in and bring something out. We do some work in the area. We have an extensive practice that works with several platforms including Appian, Microsoft PowerApps, Salesforce etc.
The last thing is that at the heart of it all Infosys is a system integrator. If there’s a technology problem or a technology challenge that health and human services agencies are facing, we can help. We are seeing things in the commercial space, in the healthcare space across the globe. We can bring insights and help agencies accelerate their transformation path.
Nick: That’s a lot of great information and options available to the industry. Thank you, Rick, for your insights on what’s next for the health and human services agencies and how to navigate it.
Nick: Thank you, our audience, for joining us today.
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