Alabama upgrades eligibility systems for health and human services


Alabama is updating its health and human services eligibility systems in order to meet new state requirements under the Affordable Care Act. The Alabama Department of Public Health (ADPH) has selected Software AG for the task, which will allow them to meet 2014 health care reform deadlines.

Through the application of Software AG’s ARIS technology and its webMethods Business Process Management Suite (BPMS), along with SOA Governance capabilities, the ADPH will be able to meet near term ACA deadlines while streamlining the eligibility and enrollment process and creating a system that automates application processing.

SOA stands for service oriented architecture, a software set up common to large, private corporations, that has been widely adopted by state and local government as a means of phasing in technology upgrades. Typically, governments with the help of systems integrators can create an architecture that brings along legacy systems while upgrading surface level user interactions. Then, over time, IT shops can work on replacing and upgrading infrastructures. With SOA, state and local governments can phase in the pay-for as well.

Under federal health care reform, medicare and Medicaid program administrators in states will need to look at how they manage issues like eligibility business processing in order to ensure compliance with and responsiveness through the new health insurance exchange model. As a result, states like Alabama are working through upgrades to both technology and business processes to meet current needs. Software AG’s services can help states automate their processes.

Alabama aims to be a model for Medicaid Information Technology Architecture (MITA) maturity guidelines provided by the Centers for Medicare & Medicaid Services (CMS). The MITA guidelines are meant to serve as a framework for states to use when implementing changes required through the Affordable Care Act in order to improve efficiency and program administration through technology. CMS also maintains an informal working group around the guidelines to provide ad hoc support.