Georgia CareConnect: Building a Shared-Service Foundation for Medicaid Modernization

As part of the Georgia Department of Community Health’s (DCH) Medicaid Enterprise System Transformation (MEST) initiative, the agency sought to create a modern digital foundation capable of supporting Georgia Medicaid’s evolving ecosystem of providers, trading partners, members, and agency personnel. 

To help them realize their modernization objectives, CapTech partnered with DCH to design and implement Georgia CareConnect, a modern digital platform that now serves as the front door to Georgia Medicaid. 

GAMMIS, DCH’s long-standing Medicaid platform, was a legacy system with outdated front- and back-end user experience that limited usability, flexibility, and modernization efforts. To transform GAMMIS from a collection of disconnected subsystems into an interoperable ecosystem of integrated modules, CapTech had to create a platform capable of integrating with multiple Medicaid modules and enterprise services. 

This required a scalable solution that could simplify access to services today while creating a repeatable framework for future systems to be added, upgraded, or replaced with minimal disruption. 

CapTech partnered with DCH to architect a shared-services platform that unifies access to information, applications, and support resources while the enabling accelerated adoption of future Medicaid modules and services.

At the center of the solution is a consolidated experience layer that connects users to the information, services, and applications they need while streamlining the navigation of an increasingly modular Medicaid ecosystem. Rather than requiring each program or module to independently implement foundational capabilities, Georgia CareConnect’s shared-services framework can be leveraged across the enterprise.

Through Georgia CareConnect, CapTech developed a common foundation that brings together:

• Persona-Based Experience Framework: CapTech designed Georgia CareConnect around the end-to-end needs of each user population, creating a persona-based experience that helps providers, trading partners, members, and agency personnel access the right applications, content, and support from a single starting point. Helping users get what they need quicker also reduces operational burdens, duplicate support channels, and downstream administrative costs.
• Role-Based Access Control (RBAC): CapTech architected and implemented a unified and scalable identity and access management model for the full Medicaid enterprise, giving users secure, role-based access to applications, content, and services while providing a consistent authentication and experience across connected systems. Establishing common identity, authentication, and authorization patterns creates a more cohesive experience that minimizes friction for users while simplifying governance, security, and administration.
• Service Management and Support: Custom integration with ServiceNow enables public and authenticated users to submit requests, report issues, monitor resolution, and engage with service teams through a seamless experience.
• Enterprise Knowledge Management: CapTech configured a centralized Knowledge Base that provides users with policy guidance, FAQs, job aids, operational procedures, and program resources applicable to their role through a single, searchable repository.
• Learning and Training Resources: CapTech integrated access to Learning Management System (LMS) content and training materials that support onboarding, education, and ongoing operational readiness.
• Digital Engagement and Self-Service: Emerging conversational support and chatbot capabilities that leverage enterprise knowledge assets help users quickly find answers and complete common tasks.

By intentionally architecting a shared-services platform that unifies numerous, previously disconnected services and processes, Georgia CareConnect strengthens health care and fosters connections across the state while enabling accelerated adoption of future Medicaid modules and services.

Key results include:

• Improved Interoperability: Enabled enterprise-scale interoperability across the Medicaid ecosystem, connecting 25 active business systems and supporting 527 file types and transaction categories, creating a flexible framework for secure data exchange and future module onboarding that continues to grow.
• High-Volume Capabilities: Supports high-volume Medicaid operations and critical program functions, processing more than 35,000 transactions through the platform’s transaction framework. Includes approximately 19,000 transactions supporting Georgia Horizons trading partners, with visibility and governance across key business processes.
• Stronger Support Services: Expanded support for Home and Community-Based Services through Georgia Horizons, providing a digital platform used by approximately 60 agencies and 1,800 users serving nearly 60,000 Georgia members. Built-in policy enforcement and DCH oversight capabilities help ensure compliance while authorizing more than 100,000 provider services each month, strengthening safeguards against fraud, waste, and abuse.
• More Flexible, Accessible, Future-Ready Platform: Georgia CareConnect features WCAG 2.2-compliant design, multilingual capabilities, integrated analytics through Tableau and Power BI, and a modular architecture that continues to support DCH’s long-term MEST strategy.
• Unified Digital Front Door for Georgia Medicaid: The new portal connects providers, trading partners, stakeholders, and agency personnel to resources, service modules, support tools, and enterprise services through a single experience.
• Recognized by Centers for Medicare & Medicaid Services as Innovation Leader: The MES Portal was highlighted as an example for other states seeking to modernize legacy Medicaid systems and create more connected Medicaid ecosystems.

Today, Georgia CareConnect serves as more than a portal. It functions as a foundational shared-service layer that connects people, processes, and technology across Georgia Medicaid.