Modernized Medicaid Portal for the Georgia Department of Community Health

The Georgia Department of Community Health (DCH) partnered with CapTech to transform its Medicaid enterprise, starting with a modern Medicaid portal solution aimed at improving outcomes for community members, partners, and stakeholders. This collaboration has been a cornerstone in DCH's efforts to enhance the efficiency and accessibility of Medicaid services for more than 2 million Georgians.

CapTech's comprehensive approach involved detailed assessments, stakeholder engagement, user-centric design, and modular architecture, ensuring a robust and scalable infrastructure. The first release of the Medicaid Enterprise System (MES) Portal marked a significant milestone, introducing a live portal website with key features such as a provider directory, news and events page, data and reporting capabilities, an intuitive contact form, translation capabilities, and more. The success of the first release has set the stage for future advancements, with the Centers for Medicare & Medicaid Services (CMS) praising the MES Portal for its innovation and usability.

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.

CapTech was selected by Georgia DCH to design and develop the first releases of the MEST. This release focused on creating a central entry point for Medicaid services with a user-centric design and seamless integration with other systems and modules. The approach included:

1. Research and Analysis: CapTech conducted thorough research across all 50 states as well as private sector healthcare insurance providers to identify best practices, trends, and areas for improvement. This paired with significant stakeholder interviewing, persona creation, and journey mapping set the foundation for the features, form, and functionality for the new Medicaid enterprise.

2. Visual Design Work: CapTech created brand guidelines to provide a foundation for the enterprise naming, logo, colors, imagery, fonts, and tone. A series of wireframes were developed to showcase the intended content, features, and functionality of the proposed experience. These wireframes included the home page, news and updates page, providers landing page, contact us form, about us pages, reporting visualizations, and more. The information architecture was mapped out, highlighting the organization of proposed content and features, and showcasing how users will navigate the site. Additionally, visual design work was completed for every page with full look and feel to match the brand guidelines – with validation held through moderated and unmoderated usability testing with state employees and health professionals.

3. Development and Deployment: The MES Portal was built utilizing assets created from research, analysis, and design with a focus on modular architecture to ensure flexibility and scalability. CapTech was engaged to develop essential features such as the provider directory, news and events, about us, reporting capabilities integrated from Tableau and PowerBI, and an intuitive contact form integrated with ServiceNow. The site was built on Salesforce and deployed following best practices in DevOps to streamline the process and ensure robust performance.

4. Testing and Validation: Extensive testing was conducted to validate the functionality of the MES Portal. This included usability tests to fine-tune the design and ensure an optimal end-user experience. All portal enhancements, content changes, reporting capabilities, accessibility, and responsiveness were thoroughly tested before going live.

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.
• Integrated reporting capabilities from Tableau and PowerBI, with visualizations for Medicaid and State Health Benefit Plan information.
• Developed an intuitive contact form integrated with ServiceNow to streamline communication and support processes.
• Implemented real-time translation services embedded into development code for Korean and Spanish translation with an additional six languages on the roadmap.
• Built all mobile and desktop components to WCAG 2.2 standards enabling ease-of-use for all Georgians regardless of any accessibility challenges.

Following the success of the first release, CapTech continues to partner with DCH on the transformation of its Medicaid Enterprise.