Come October, Iowa expects to have a new human services eligibility system online — less than a year out from starting the project.
The timeframe is ambitious, as eligibility system rollouts can often take years to fully implement. Just ask Texas, which spent eight years getting its project done. But as Iowa Department of Human Services Administrator Ann Wiebers explained, the rapid overhaul is a necessary step for the state to meet some of the requirements of the Affordable Care Act (ACA).
The ACA requires states to have online health insurance exchanges established by January 2014, so that citizens can purchase health coverage. But Wiebers said Iowa’s eligibility system wouldn’t be able to provide the real-time Medicaid determinations needed so that an exchange can work properly. Built in the late 1970s, the front end of the current system was installed in 1983 and isn’t easily upgraded.
“It is very difficult to change and it takes a significant amount of effort … and we knew that in order to do a seamless integration with the exchange that we had to replace it,” Wiebers said. “There was no discussion about trying to put a [new] front end onto the mainframe because it was so old.”
Iowa chose Accenture to handle the new eligibility system implementation. Debora Morris, managing director for integrated services for Accenture, said the age of the state’s current system isn’t necessarily a challenge for the company, but in order to meet Iowa’s Oct. 1 project deadline, the company had to forgo a phased implementation process.
Accenture will instead install the new system and have it running immediately. Then in the months and years to follow, they’ll add enhancements based on the state's RFP as well as suggestions from workers using the system.
Morris added that the major challenge on Accenture’s part is working without final details from the federal government on the health benefit exchanges.
“We’re doing this at a time when the feds are still getting out some of the guidance to states and building out their federal exchange,” Morris said. “So there are a few unknowns out there that we’re working a little blind on.”
From Iowa’s perspective, they’ve been prepping for quick turnaround of the eligibility system for a while. The state got its RFP out for the project last January and in December, they announced that Accenture was awarded a six-year base contract through 2018 with four one-year extension options. The total value of the contract over 10 years is approximately $77.7 million and includes software, hardware, maintenance and training.
Weibers said that Iowa also spent the latter part of 2012 evaluating how its current eligibility mainframe connected to its separate Iowa Automated Benefits Calculation (ABC) System. She called ABC a “workhorse” that interfaces with more than 100 different subsystems. State personnel were identifying all those connections to make sure all functions were accounted for so Accenture had no surprises when starting the transition.
Given the short timeframe, Iowa is also supplementing its support staff in the Department of Human Services. In addition to hiring Accenture, the state has hired a project oversight, management and implementation contractor and a quality assurance and independent verification and validation contractor. Another “seven or eight” positions were also built into the project budget to augment state staff.
Wiebers added that the contractors hired have worked on other eligibility system projects in the past and are sharing lessons learned with the staff. Iowa is also in close contact with California and Idaho, who operate the same Accenture system and are willing to share their experiences.
“I think that we have done everything that we possibly can to mitigate any issues,” Wiebers said.