waiting room

Agile helps Alabama build portal for shift to Medicaid

HealthCare.gov is not the only health portal. 

As part of its move to provide health care insurance to children under the Affordable Care Act (ACA), Alabama tested and launched a new online portal on Oct. 1. Replacing the state’s 30-plus year old Medicaid system, the eligibility and enrollment portal is being developed in-house through the Alabama Department of Public Health. Agencies expect to save $20 million in state and federal funds.

As part of the ACA, approximately 25,000 Alabama children currently covered by the state’s ALL Kids program and CHIP, the Children's Health Insurance Program, will have to be moved to be covered by Medicaid. The change takes effect Jan. 1, 2014.

Dr. Don Williamson, Alabama's Public Health Officer who's served as the Interim Commissioner since February 2012, was quoted in a local news report saying that the two programs will be “pretty comparable in terms of cost.” 

Because of the quick launch schedule, the system was developed using agile design methodology for flexible and rapid development, said Medicaid Deputy Commissioner of Beneficiary Services Lee Rawlinson.  Agile design is based on iterative and incremental improvements.

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,” Rawlinson said. 

The portal was developed with the Alabama Medicaid Agency, the Alabama Department of Public Health and the Alabama ALL Kids program. Employees from the governor’s office and the Alabama Department of Human Resources were also on the project team, state officials reported

Through the portal, applicants can create accounts for the ALL Kids program or for Medicaid coverage for children, pregnant women or women seeking family planning coverage through Plan First. Applicants can also apply for tax credits or other subsidies to purchase health insurance through the federally-facilitated insurance exchange (FFE) within the portal.

Unfortunately, only 658 applications were submitted through the portal during its first month of operation, a fraction of the number of Alabamians without insurance. A greater number of individuals registered, with 1,350 accounts established during the month.

The next phase of the portal implementation will be to add the state’s Elderly and Disabled programs to the system by the end of 2015. Other programs the state plans to add include Temporary Cash Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP) and Child Care, which, if approved by the Centers for Medicare and Medicaid Services, would be integrated into the new system by December 2015.

Most state exchanges are working better than HealthCare.gov. Under the Affordable Care Act, states could set up their own exchanges, rely on the federal site or develop a combined state/federal “partnership” site.

HealthCare.gov has been plagued by a number of problems, including insufficient beta testing, a day-long data center outage that affected all 50 states, and a denial-of-service attack tool targeting the site (although an analysis of the tool concluded it is unlikely to affect availability of the site).

About the Author

Kathleen Hickey is a freelance writer for GCN.


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