arouault/iee-roadmap

Vermont's Integrated Eligibility & Enrollment Program Roadmap

IE&E Roadmap

Vermont's Integrated Eligibility & Enrollment Program Roadmap

Welcome!

This website contains information about the Vermont Agency of Human Services' Integrated Eligibility and Enrollment (IE&E) modernization project. It is intended to provide a place where project participants and interested parties can keep track of the overall project goals, progress to date, and planned work.

Vision

The IE&E Program will ensure efficient service delivery that lowers administrative costs, streamlines processes, and ensures the cost of system maintenance is sustainable over time.

Goals

Improve the customer experience in the following ways:

• Provide a united application, determination, and enrollment experience that allows the customer to engage with the State through the channel of their choosing.

• Facilitate a simple, user-friendly experience that allows the customer to maintain continuous benefits, services, or health coverage, especially during critical life transitions.

• Ensure accurate and timely determination and notification of eligibility.

• Deliver clear and concise information throughout the eligibility and enrollment process through the customer’s chosen method and language.

An integrated IE&E technology system will also ensure:

• Staff can serve Vermonters efficiently and effectively by maximizing focus on Case Management and Customer Service.

• Vermont can meet Federal and State mandates and requirements.

• Improved data integrity and robust access to data for analysis, reporting and modeling.

• Financial integrity in the administration of benefit programs.

Product Roadmap

This is where we communicate our IE&E strategy and delivery plan. The first column contains mission, vision, goals, objectives, key stakeholders, and program promises. The second column contains increments of work ordered from top to bottom according to the team's current strategic focus areas. Each increment of work is intended to move the program forward in achieving its goals while providing incremental benefits. The products are in sequential order and track value proposition, key stakeholders, program promises, and key performance indicators (KPIs).

It is important to understand that the State’s roadmap will evolve over time as new information/experience is gained and the marketplace evolves. The roadmap outlined here represents the State's most current thinking which will be updated as planning and implementation unfolds.

IE&E Roadmap

Why We’ve Changed Our Approach

The State’s Integrated Eligibility & Enrollment (IE&E) Program is a multi-year business and technology transformation project which will streamline the eligibility and enrollment experience for health coverage and financial assistance programs incrementally. Many operational and technical inefficiencies exist today, leaving customers with an eligibility and enrollment experience that is often disjointed, uncoordinated, and burdensome. The current legacy system is inflexible, not designed with users in mind, expensive, and a challenge to enhance. The system is also out of compliance with federal mandates.

In the past, Vermont has taken a rather risky, big-bang approach to procuring IT solutions and that will change going forward. Because the former approach was all-encompassing, if we were to get it wrong, there wasn’t flexibility to make changes, and customers would suffer.

Our New Approach

The IE&E Program will put the business first, meaning we will clearly understand the business problems and will build for the users, not pre-determine or force-feed a technical solution.

The IE&E Program will also take smaller financial risks by taking a modular approach to developing its solution, or breaking up requirements into smaller, more readily manageable chunks of work. This approach allows the IE&E Program to find the best vendor for a specific need while also reducing vendor lock-in, thus mitigating risk, all the while delivering value to users more rapidly.

The IE&E Program will also utilize an Agile development methodology, enabling nimble decision making as we learn and the ability to course-correct as we go, resulting in a greater opportunity to achieve our desired outcomes. This incremental approach to delivering value to users, with their needs driving decisions, is a bottom-up instead of top-down mindset.

Key Products

Ongoing

Healthcare Paper Application Usability

• Problem: Healthcare paper applications contain essential information needed for staff to process health benefit eligibility determinations decisions. Currently, paper application forms are out of compliance with the Federal mandate to have a single application for all MAGI and non-MAGI healthcare programs. Additionally, the forms do not comply with plain language requirements, making it harder for applicants to complete the application correctly, often leading to requests for additional information which in turn causes processing delays.

• Vision: A newly designed paper application, branded with VT logo and colors, that is easy for applicants to complete, enables full healthcare screening for both MAGI and non-MAGI based eligibility determinations, collects information needed for efficient and accurate eligibility decisions, and reduces data entry and processing time for staff.

Enterprise Content Management

• Problem: Currently, Vermont eligibility and enrollment staff utilize two enterprise content management (ECM) systems for scanning, indexing, workflow and viewing Vermonters’ documentation and notices. This leads to operational inefficiencies, unnecessary maintenance & operations costs, and difficulty coordinating enrollee documentation across programs.

• Vision: To utilize one system to scan, index, manage workflow, and view Vermonters’ documentation and notices. By utilizing only one system, ECM will create a streamlined experience and process for staff that is user-friendly and more efficient for the State to maintain. Training, documentation, and processes will be easier and faster resulting in less waste and improved quality.

Customer Portal Phase I: Verification Documents

• Problem: Vermonters find satisfying verification requirements to be a challenging, time-consuming, and frustrating experience. For staff, verifying Vermonters’ income (and other requirements) routinely involves delays, stressful conversations, and duplicative work. Mail and paper slow the entire process from initial notification, to mailing documents, to scanning and indexing. Internal staff wait for Vermonters’ submission of required documentation such as pay stubs, employment forms, or attestations to process applications or changes, which lengthens the eligibility determination process.

• Vision: To make it easier for Vermonters to submit- and staff to process- manual verification documentation. We will implement a technical solution which allows Vermonters to utilize mobile and online technology to submit verification documents and to automate the classification of these documents. This solution will improve the efficiency of the eligibility determination process and result in a better customer experience for Vermonters.

Business Intelligence

• Problem: The current reporting system used by Vermont Health Connect (VHC) is expensive, complicated, and does not perform to our standards. It requires outside contractor expertise to support and is manually intensive and time consuming for State staff to maintain. It also means that VHC data is housed separately from the rest of IE&E Program data, which is in Microsoft SQL Server.

• Vision: To align data storage and reporting for MAGI health coverage programs with the other in-scope benefit programs for IE&E, by migrating the data from the OBIEE data warehouse to Microsoft SQL Server. The new system will be easier for staff to use, enable self-service, and allow for real-time reporting and analytics. It will also be more affordable and enable in-house State of Vermont expertise to sustain support and maintenance of the solution.

Upcoming

Customer Portal Phase II: Single Online Application- A single, streamlined online application which will be used to apply for all healthcare and financial benefit programs in scope for the IE&E Program.

Notices- A notice system that provides timely, accurate information to Vermonters in a way that promotes action and understanding on their part.