Modernized Medicaid Portal for the Georgia Department of Community Health

The Georgia Department of Community Health (DCH) partnered with CapTech to create a modern Medicaid portal solution to improve usability and transform Medicaid technology across the state of Georgia.

Georgia DCH administers the state’s Medicaid program and provides healthcare coverage for more than 2 million Georgians. Georgia DCH’s existing Medicaid Management Information System (GAMMIS) relied on a traditional legacy system responsible for essential business functions like claims processing, payment, and provider enrollment.

In recent years, DCH saw a need to modernize the legacy system to improve navigation and usability to increase productivity and create an experience that is more accessible and encourages self-service. As a result, DCH leadership sought a solution that leverages new Centers for Medicare and Medicaid Services (CMS) guidelines for Streamlined Modular Certification (SMC) to create a flexible, service-oriented architecture.

To manage the replacement of GAMMIS, DCH established the Medicaid Enterprise Systems Transformation (MEST) program. Through MEST, DCH is creating a “best of breed” interoperable solution with integrated modules that increase flexibility and efficiency, modernize and simplify technology — and most importantly — improve the user experience.

Georgia DCH selected CapTech to partner with them to design and develop a modular system prototype consisting of a central entry Medicaid Enterprise System (MES) Portal with integrations to other systems and modules focused on intuitive design and user operability.

The first phase of the project included a full assessment of existing system functionality and integrations, an in-depth comparative analysis of the Medicaid Enterprise System landscape, and gathering stakeholder insights and research. These efforts resulted in the design of a user-centric and intuitive digital experience, including a detailed sitemap, wireframes, and initial visual designs to serve as the foundation for future implementation.

Additional deliverables included the future state architecture, a strategic product roadmap, statement of requirements, licensing analysis, and the initial proof of concept (POC) for the MES Portal.

CMS praised the new MES Portal for its innovation, citing it as an example for other states looking to modernize their legacy systems.

Project highlights include:

• Delivered a modern Medicaid portal solution built off flexible, modular infrastructure that delivers an exceptional user experience and allows for seamless updates and integrations.
• Created a channel for providers, partners, and stakeholders to access service modules, resources, and support tools.
• Crafted an intuitive user experience and designed paths that allow all users to access information based on their individual needs. 
• Designed webpages that showcase featured content, dynamic communication, secure access to various resources, and easy access to Medicaid programs.

Due to the success of the POC, CapTech will continue to partner with DCH on the building of the MES Portal.