ESAR Case Study: Reducing complexity and increasing visibility to modernize Washington’s eligibility system

Even before the passage of the Affordable Care Act (ACA), Washington State, in partnership with Treinen, was preparing for changes to eligibility. So when this health care overhaul was handed down to states, Washington had less work to do in setting up the systems and could dedicate more effort into implementing ACA and related programs effectively.

Since our involvement on Washington’s Automated Client Eligibility System (ACES) and now on the Eligibility Services & ACES Remediation (ESAR) project, Treinen has successfully partnered with the Washington State Department of Social & Health Services (DSHS) to modernize its systems. Our success is due in large part to breaking the large project into more manageable tracks, managing the financial picture as a whole, and integrating organizational change management (OCM) activities into project management activities.

Compartmentalizing the project into tracks

As with other states, updating 25-year-old infrastructure for an agency supporting multiple programs is a major undertaking that requires coordination, communication and adequate funding.

Treinen reduced this complexity by breaking the project into five independent tracks:

  1. Application Lifecycle Management (ALM) Tools – Improving the tools and processes that support Software Development Life Cycle (SDLC)
  2. Data Reduction – Reducing the inventory of reports and data to minimize potential security exposure as well as the effort for other ESAR project tracks.
  3. Mainframe Rehosting – Reducing the dependency on legacy mainframe technologies, making the system more adaptable to future modernization.
  4. Database Modernization – Providing a new normalized relational database and related code changes to the eligibility system.
  5. Eligibility Rules Migration – Providing a single, integrated Business Rules Management System that includes all eligibility decisions, allowing for faster and more accurate changes to the system.

There are several benefits the project has realized and will continue to realize with these tracks. First, each track is managed individually, so they can move forward on their own while also working in concert with overall ESAR goals. The individual tracks are independent efforts with their own value for the project and the agency that standalone from other tracks.

Next, the tracks are individually measured against their own success criteria and schedules. This brings increased visibility to each track, communicates the importance of each within the project, and reduces the overall risk to the project as the tracks are not interdependent on each other to move forward.

Finally, modularizing the project into independent efforts benefits the funding effort for ESAR, as the U.S. Centers for Medicare & Medicaid Service (CMS), the major Federal partner, prefers states break things out to simpler efforts they can measure.

Dedicated financial management

In addition to the five project tracks, Treinen also provides the financial management for the project. This goes beyond managing the budget for the project itself by providing leadership in obtaining funding from federal and state sources. This include the following:

  1. Developing Cost allocation methodologies
  2. Facilitating the requests Federal and State funding (APDs and DPs respectively)
  3. Meeting Federal (CMS, FNS, IV&V) and State (OCIO, OFM, QA) compliance.
  4. Supporting Washington State Medicaid Enterprise Governance

Integrating OCM into PM activities

The project is unique in that the “business” is the IT staff, and their current processes and rules will change with the completion of this project. To say that people are important here is an understatement. Treinen, in conjunction with the client, identified the need for an Organizational Change Management practitioner to guide the staff and project team through the dramatic changes occurring.

In order to ensure the integration of OCM in the project, the OCM expert is an integral member of the project management team. This approach is helping the agency adopt the changes.

We treat every activity as an OCM opportunity, and project management meetings are also change management meetings – they are not separate. Our quarterly updates, in the form of newsletters, are sent to the staff and executives provide project management updates, and they serve as a change management tool.  The Economic Services Administration is looking to make this integrated team the model for all projects going forward. Modernizing a large agency’s infrastructure can be a daunting task and one that many organizations have never been through. Using the Treinen approach of organizing the project into tracks, applying focused financial management, and integrating change management activities, every state can be prepared for modernization projects with confidence.