Since the advent of Medicaid in 1965, state governments have served as repositories for sensitive health information of their constituents in order to provide low-income families access to affordable healthcare. As the years passed, health departments began to face the costs of having this information stored in legacy systems that operate on old and outdated technologies. Moreover, these systems required constant maintenance related to evolving regulatory conditions and general upkeep. This problem was exacerbated in 2010 when the Affordable Care Act passed which expanded the eligibility conditions for Medicaid and led to even more information being stored in these systems.

In an effort to solve this problem, many states have contracted with private companies that have developed modern Medicaid systems. Moving to an “off-the-shelf” system allows these states to process claims at a faster rate, offer a more user-friendly interface that they don’t have to maintain, and save on burgeoning legacy costs. When another state decided to move off of their legacy platform and adopt an off-the-shelf Medicaid system, the system provider determined they needed a way of understanding what policies were in the current system in order to identify if all the relevant policies were already included in their system or if some needed to be imported in. In order to do this, this system provider contacted EvolveWare to see if the Intellisys platform could help automate this process for this state’s Medicaid claims system, while ensuring that no policies were left out.