In Louisiana, those ideas were already in motion under the stewardship of Dickie Howze, CIO since 2013, whose consolidation plans had saved the state $75 million in their first year.
But since January of 2016, when Gov. John Bel Edwards signed an executive order expanding Medicaid coverage under the Affordable Care Act, Louisiana’s Medicaid Eligibility and Enrollment program has undergone a $65 million modernization — one that has ultimately sparked a renewal of state agencies’ online enterprise architecture.
The results won’t begin to go live until later this year. But they amount to a wholesale technological shift away from mainframes and time-consuming tape backups to virtualized machines and integrated systems — one which, because of a partnership with federal officials, received significant financial support from the feds.
The state’s Office of Technology Services worked with Palo Alto-based VMware to stand up a new statewide hyper-converged platform from Nutanix with VMware’s ESX hypervisor technology and its NSX virtualization.
The goal was far-reaching, said state Chief Technology Officer Michael Allison in a statement: Create a stable, scalable platform that could handle the modernizations and incorporate “a hodgepodge of technologies,” including “thousands of applications spanning all kinds of sectors.”
VMware also worked with Louisiana to build a private, on-premises cloud — and is developing a partnership with Amazon Web Services to create a public cloud as well.
Long-term, Louisiana wants to adopt a public cloud-first strategy, Allison said, characterizing AWS’s Lighthouse program as “a view into something the state never had before because we never worked with private commercial entities in shaping the solution.”
“This is where we believe the secret sauce will be,” Allison told Government Technology.
Louisiana officials said the timing of their push to consolidate IT coincided with new federal Centers for Medicare and Medicaid Services standards, and they were able to leverage federal money focused on Medicaid — with a 10 percent state match — to design statewide solutions.
“Originally it was only going to be for the Medicaid project, it was going to be an enterprise architecture project of limited scope," said Matthew Vince, Louisiana’s chief design officer. "That was pre-consolidation. Post-consolidation in the state, we realized there was a whole lot of benefit of building once."
“The challenge was, ‘Can I take Medicaid funding and come up with something that presumably everyone could use?’” he added.
Allison agreed.
“The timing was just right, to have this project come up as we were consolidating and have this project be the one that we adopt enterprise-wide," Allison said. "Planning ahead to make sure we are not putting ourselves in the position of building monolithic systems like the state has done in the past."
Along the way, the state has saved an estimated $1 million in hardware costs — and designed a system it believes will come across as seamless and agnostic, presenting an improved experience that transcends equipment and software.
Tim Merrigan, vice president of state, local and education (SLED) at VMware, agreed that consolidation was a primary force driving the project, but said the results — particularly the move to the cloud — should enable state IT to “evolve into a broker of IT services,” not having to build everything on premises but retaining that option.
“This is the next step of how we can help to drive out cost," he said. "And helping IT to focus in on their mission of helping agencies deliver on their mission."
The state’s new streamlined Medicaid process, through its Department of Health (DOH), an early adopter of the new architecture, should enter production next month and debut in August. Agencies likely to make use of the platform and technologies slightly later will include the state’s departments of Children & Family Services, and Transportation & Development, Vince said.
Louisiana's aim, Vince said, is to modernize as effectively and broadly as possible. He characterized employees’ likely experience with the new systems as “pretty substantially different.”
“The current system is mainframe so we’ll be going from terminal to Web-based, it’ll be responsive, mobile-ready. Their day-to-day will change significantly in just the way they experience the applications,” he added.
Bill Perkins, the state’s deputy Medicaid director, said the new architecture should ease the process for employees and residents alike as it will better connect roughly 400 disparate computer systems — and keep DOH live 24 hours a day instead of requiring around 12 hours a day for maintenance and reports.
He characterized the modernization of Medicaid enrollment, which is administered by DOH, as a way to work with new vendors that could tailor solutions for specific state agencies rather than developing another one-size-fits-all system.
“As we’re putting together this enterprise architecture, that allows us to put together these different modules and make sure they’re integrated as one," Perkins said. "It is going to be more difficult to have different vendors potentially, but I think at the end of the day we’re going to have a better product in totality."
State officials, he said, have already enrolled around 406,000 residents for Medicaid through ACA since the governor’s executive order, but ultimately hope to register at least a half-million people.
