Case Study
Objective
Meet the Medicaid healthcare
insurance needs of state citizens while
simultaneously preparing for future
changes in the healthcare industry
Oklahoma Health Care
Authority provides cuttingedge Medicaid service
Dramatic reduction in Medicaid enrollment
time from 20 days to 20 minutes
Approach
Leverage a scalable Medicaid
Management Information System (MMIS)
technology platform and flexible pool
of outsourced technical resources to
develop and manage an Online Medicaid
Enrollment program
IT Matters
• Flexible MMIS ensures state can
respond to changes in healthcare
industry more flexibly and costefficiently
• Robust HPE managed MMIS allows
OHCA to accommodate the unexpected
• Hewlett Packard Enterprise IT expertise
supports OHCA productivity needs
Business Matters
• Convenient self-service online Medicaid
enrollment helps the state meet its
goals of serving its citizens quickly and
easily from eligibility confirmation to
benefits coverage
• Enrollment time greatly reduced in
some instances from 20 days to 20
minutes allowing same day access to
healthcare
• Efficiency improvements through
automation help the state
accommodate healthcare programs
with reduced administrative costs
Oklahoma Health Care Authority (OHCA)
works with Hewlett Packard Enterprise
(HPE) to provide online SoonerCare
(Oklahoma Medicaid) claims processing to
Oklahoma residents. In its role as fiscal agent,
Hewlett Packard Enterprise implemented
and maintains a Medicaid Management
Information System (MMIS) for accepting and
adjudicating Medicaid claims. In partnership
with OHCA, HPE served more than 42,000
providers processing over 63 million claims for
over 1 million members in 2014.
The healthcare industry is experiencing
immense change—and as a result, state
governments that administer the federal/
state Medicaid program may find themselves
rushing to respond to shifting federal
mandates and the changing expectations
of their members. Due to a relationship with
Hewlett Packard Enterprise that spans more
than 15 years, the state of Oklahoma is well
positioned to meet new requirements.
Oklahoma’s MMIS is a robust and flexible
national showcase designed specifically to
accommodate the unexpected. So when
OHCA needed to enhance its HPE-managed
programs to offer same-day eligibility and
enrollment services, current Affordable Care
Act support and a plethora of new features,
it relied upon its durable and successful
relationship with Hewlett Packard Enterprise.
“We made a strategic decision in 2000 to
implement and outsource a new MMIS,” says
Nico Gomez, OHCA CEO. “We determined
it needed to be extremely flexible because
we knew there would be constant changes,
changes we couldn’t even contemplate at
the time. Through the state’s competitive bid
process, we contracted with Hewlett Packard
Enterprise. HPE brought the design and
management expertise that was needed for
the project. This success has resulted in, a
relationship that is still going strong today.”
Case study
Oklahoma Health
Care Authority
Industry
State healthcare
Page 2
Since the original implementation of its
HPE-designed MMIS, OHCA has impressively
kept ahead of a vast array of changing
and evolving State and Federal Medicaid
requirements and regulations.
Lisa Gifford, Chief of Business Enterprises
at OHCA, cites an example of the system’s
built-in flexibility. Within months of
implementation, the system needed to grow
from three SoonerCare health products to
10, each with different benefits and eligibility
requirements. “We would never have been
able to accomplish this so smoothly if it
weren’t for the design decisions and flexibility
that HPE made when it planned the system,”
she emphasizes. “It was a fairly simple and
inexpensive process that proved the design.”
Sharing success
When the Affordable Care Act came online in
2013, OHCA and HPE had been operational
with its leading-edge online Medicaid
eligibility system for a remarkable three years.
OHCA personnel appear on national panels
and conferences and regularly host other
states, who come to study the success of the
HPE-designed and -managed MMIS.
Derek Lieser, Director of Enrollment
Automation & Data Integrity, OHCA, further
illustrates a few of the features that make
the Oklahoma system stand out. “Our online
SoonerCare system goes several steps
beyond the average implementation,” he
explains. “HPE helped us design and deploy
real-time eligibility determination. Once this
is determined via a short process, the citizen
can enroll immediately into the aid category
for which they qualify, and ultimately see a
provider on the same day! We’re the only
state that can provide same-day turnaround
to people needing Medicaid benefits.”
HPE works closely with OHCA to understand
its specific needs and designs strategically for
the most effective results. “The unique ability
to determine eligibility and then progress to
active health services on the same day is the
kind of strategic and highly-integrated service
we want to give the Oklahoma public. Our
working relationship with Hewlett Packard
Enterprise is the key,” echoes Gomez. “HPE
meets with us, listens to us, brainstorms with
us and then actualizes the design. It’s a very
communication-centric relationship. HPE is
very instrumental in our status as a showcase
state.”
Hewlett Packard Enterprise not only created
and implemented the online eligibility system,
it manages the entire Oklahoma MMIS for
OHCA, consisting of SoonerCare claims
processing from beginning to end, clinical
case management system support, customer
call-center, management and reporting,
and others. It’s a complete one-stop-shop
outsource solution.
Oklahoma SoonerCare
goes mobile Sooner
rather than later
Recently, HPE has further enhanced
MySoonerCare, the self-service portal which
has become a very popular feature among
SoonerCare participants. It’s available in
English and Spanish and adaptable for
additional languages as needed. The portal
now allows the member to log on and change
providers, through federally-mandated
browser-neutral access, at any time of the
year. And to make all the new features highly
available to the state’s population, HPE
implemented mobile access to the system,
supporting the breadth of available mobile
devices. HPE also implemented the ability to
use email correspondence for quick support
and instant user feedback. These electronic
media initiatives are consistent with OHCA’s
‘going green’ effort to reduce the costs of
paper and postage.
“The single component that makes our
implementation a showcase for innovation is
the great care HPE has put into executing our
major instruction—make it flexible, designed
to modify and evolve,” says Gomez. “HPE
developed with reusable code. For example,
since we now support email, as we next move
to support text messages, we can reuse much
of the same code. The design is very efficient
and therefore, economical.”
Case study
Oklahoma Health
Care Authority
Industry
State healthcare
Customer at a glance
Application
With technology designed and managed
by Hewlett Packard Enterprise, Oklahoma
Health Care Authority enhances its
ability to serve its citizens who qualify for
SoonerCare benefits.
Services
• Government Healthcare Business
Process Services
–– ePrescribing
–– Healthcare Portal Solutions
–– HPE interChange
“Our partnership with Hewlett Packard Enterprise has been
invaluable over our 15-year relationship. It has expanded
our ability to be responsive to the needs of Oklahomans,
while also helping us to meet our constantly evolving internal goals and objectives.”
— Nico Gomez, CEO, Oklahoma Health Care Authority
• Commercial Cards Services
Furthermore, the HPE-managed MMIS
centralizes many data feeds into a main
hub, fulfilling another federal requirement.
Multiple sources of federal information
are automatically accessed and integrated
into achieving the final goal, to be seen by
a physician the same day. Efficiency and
productivity are maximized on all fronts.
“HPE now processes approximately 1,200
SoonerCare ID cards for OHCA daily and
all cards are processed within 24 hours of
the request,” adds Lieser. “We’ve amazingly
reduced enrollment time from 20 days to 20
minutes. And very key for our accountants
and our members alike, automation supports
efficiency improvements to help the state
accommodate more healthcare programs with
less budget.”
Hewlett Packard Enterprise
treats OHCA business
goals as its own
Lieser believes that working with HPE is like
having an additional department of likeminded employees next door. They are a
team. The HPE-managed data center runs
24x7, and all support issues, both hardware
and software, are also handled on a teamwork
basis as discussed and prioritized. Hewlett
Packard Enterprise manages SoonerCare
online enrollment, eligibility determination
and claims processing, as well as call center
platform and Internet helpdesk support for
members and providers. And HPE recruits
and trains the state’s providers on navigating
the MMIS process and website.
“Currently over one million Oklahoma
SoonerCare members count on our ability
to react flexibly and quickly to ensure they
have timely access to needed healthcare,”
concludes Lieser. “Today up to 4,000
Oklahomans touch the website each day
and complete 30,000 applications monthly.
They need to easily understand and be able
to navigate the process. HPE has done an
outstanding job in setting up a very usersuccessful site. Believe me, the fact that we
have few complaints means it’s working well
and a lot of citizens are getting good and
timely healthcare. That’s satisfying.”
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