Breakthrough Insights

Overcoming the Challenges of State Health Systems

After the issue-plagued launch of last fall, much attention has been paid to the national health exchange website, but there are challenges facing the state exchanges as well. Congress has called for an investigation into the programs in Oregon, Maryland and Massachusetts, which together received more than $500 million from the federal government and have produced some of the lowest enrollment numbers. A recent study from consulting firm Avalere Health gauged progress for state enrollment programs compared to the national and found that the federal healthcare site has achieved 48 percent of its goal, while state-run exchanges are 72 percent of the way to reaching their goal on average. But there is a lot of variation from state to state. As of the time of the study, Arkansas had only achieved 18% of its projected enrollment while on the other end of the scale California has exceeded its projections with 118%. Screen-Shot-2013-09-24-at-10.07.41-AM

Building a reliable system as complex as these projects demand is no small feat. Hard delivery dates have contractual, monetary or legal repercussions, and that means tracking requirements and getting testing involved as soon as a change occurs at any level, is essential.

For an example of a state healthcare system project that did go well, let’s look at the work Deloitte Consulting did on the State of Montana’s Medicaid and welfare-management system.

Deloitte was hired under a tight deadline, to modernize the State of Montana’s Medicaid and welfare management system. The project had more than 10,000 requirements and 5,000 test cases. Knowing that emailed documents and spreadsheets wouldn’t work for this project, the team selected Jama for requirements-management, traceability and testing needs. By using Jama, Deloitte was able to quickly validate requirements by effectively incorporating both client and team input. This led to the team being able to deliver a high-quality system that passed the test with the state, on

Deloitte met the deliverables of the State of Montana project with several tangible benefits:

Requirements validation — The first milestone for the project was to analyze the 10,000 requirements and distill them to what was going forward into design. By taking advantage of Jama’s automated import/export round-trip feature and customizable workflows, the project team accelerated the review and approval process.

Traceability — Using the traceability reports in Jama, the project team uncovered orphan requirements and made sure that they were pulled into design. The State of Montana and its independent verification and validation vendor could verify that requirements were being met by the design, and that testing provided acceptable coverage.

Test case management — When test management features tightly integrate with requirements management capabilities, Deloitte could make updates to test cases directly in the solution instead of having to resubmit updated deliverables to the State of Montana team.

Transparency between teams — Communication and collaboration were the keys to the transparency between the Deloitte project team and the State of Montana’s project team. Deloitte was able to stay in constant contact with both the team members and the vested stakeholders in the project’s achievements with Jama’s embedded collaboration capabilities.

When it comes to modernizing existing healthcare programs and implementing new ones, there’s too much at stake to leave requirements and test management up to text documents and spreadsheets. There is a better way to complete these projects on time, while reducing errors and better connecting the involved teams. Read the case study to get the full story on Deloitte Consulting’s success in modernizing this complex government human services system.