Case Study 4.5.2017

Implementing A Pediatric Medicaid Program

Trexin implemented an innovative program serving pediatric members with special health needs in a changing corporate environment.

Business Driver

Our Client, one of the largest customer-owned health insurance companies in the country, asked Trexin to implement an innovative state Medicaid program in a changing corporate environment. This program, which serves pediatric members with special health needs, differentiates itself by focusing on long term care and service coordination as a means to improve the health of its patients and reduce cost. Given the tight timelines between the winning bid and member onboarding, as well as the ever changing state requirements, our client needed a new delivery mentality and approach.

Approach

Drawing on Trexin’s Solution Delivery experience, our Client tasked us with introducing their project management and capability teams to the Agile methodology. While Agile accommodated the continuously changing state requirements and internal variables, the state’s demand for a traditional project plan and the Client’s unfamiliarity with Agile necessitated the use of key Waterfall practices. Essential to this transitional approach, the Client asked us to work collaboratively with their business, IT, and project management groups to design, setup, and operationalize the Medicaid program.
The Client endorsed a four-phase delivery model that leveraged smaller empowered teams (Pods) which were collocated and staffed with multi-functional roles. Central to the approach was a new model of collaboration among all areas (business, IT, and management across all functions) resulting in shared model components including one integrated program plan, one set of requirements, a single test plan developed early in the program, and fully transparent deliverable-based reporting.
This approach relied on following elements: leveraging current client capability teams in the near term, realigning meetings around a focused streamlined project structure, real-time issue escalation/resolution, a scaled-iterative delivery model, and progressive elaboration for requirements.

Results

Our Client delivered a functional and robust healthcare program at go-live, receiving recognition from the state applauding a seamless rollout. After enabling the project management and capability teams to master Agile methodologies, Trexin successfully transitioned project delivery management to the Client by go-live, with Trexin remaining in a coaching and supporting capacity. Building on the go-live success, Trexin helped the Client close out all crucial post go-live operational issues. The plan’s successful implementation paved the way for the Client to pursue other opportunities in the Medicaid space and served as an example for future implementations.

Tagged in: Healthcare, Solutions Delivery
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