From the outset, the task of creating a new eligibility and enrollment system that would comply with the requirements of the Affordable Care Act posed a challenge. There was a short timeframe to complete it, many new federal requirements had been issued, multiple state agencies were involved and it was a technically complex project. 

However, thanks to the collaborative efforts of the Alabama Medicaid Agency and the Alabama Department of Public Health and the Alabama ALL Kids program, the first phase of a new online system has been successfully developed, tested and launched on schedule and at a savings to taxpayers. Members from the governor’s office and the Alabama Department of Human Resources have been involved on the project team as well. 

Launched October 1, the new online portal allows applicants to create accounts and submit applications for ALL Kids coverage for children or for Medicaid coverage for children, pregnant women or women seeking family planning coverage only through Plan First. The portal is also available for those applying for tax credits or other subsidies to purchase health insurance through the federally-facilitated insurance exchange (FFE). During the portal’s first month of operation, 1,350 new accounts were established and 658 new applications were submitted through the portal. Applications for Medicaid and All Kids will be processed as they are received while applications for tax credits or subsidies will be forwarded to the federal exchange for action. 

The new system will eventually replace the existing architecture and structure of the current Medicaid system which is over 30 years old and suffers from inefficiencies common to older, outdated systems. By developing the system in-house through ADPH, the two agencies expect to save $20 million in state and federal funds. 

Because of the project’s short timeframe and other limitations, developers and staff worked closely together using an agile design methodology, an adaptive process based on iterative and incremental improvements, allowing for flexible and rapid development, according to Medicaid Deputy Commissioner of Beneficiary Services Lee Rawlinson.

Once the decision was made to build the system in-house, several teams worked concurrently to review policies, determine workflows, design and test the system. “What we have learned is that by using an agile approach, the final product not only met our expectations, but met with federal approval as well,” she said. 

Once the first phase is completed, the next step will be to add the state’s Elderly and Disabled programs to the system by the end of 2015. The state also plans to add Department of Human Resources programs such as TANF, SNAP, and Child Care. If approved by the Centers for Medicare and Medicaid Services, these programs would be integrated into the new system by December 2015 as well.