Case Study: Arizona Health Care Cost Containment System
Enabling Web Access to Medicaid Member Information
Arizona Health Care Cost Containment System (AHCCCS) selected HostBridge to allow for rapid integration of its CA Ideal applications. By using HostBridge, AHCCCS developed Web services that integrated Arizona’s Medicaid system into the MyAHCCCS.com Web portal.
Since its founding in 1982, the State of Arizona Health Care Cost Containment System (AHCCCS) has earned national acclaim for its managed care concept and become a model for other state programs. As Arizona’s Medicaid program, AHCCCS contracts with a range of providers to deliver health care coverage and reinsurance to more than one million recipients. The organization’s goal is to provide quality services while controlling costs. Recently, AHCCCS chose HostBridge to make mainframe-based information resources accessible via the Web by its Medicaid membership and the statewide health care community.
“Our two initial HostBridge roll-outs are going very well,” says Rich Kocher, Systems Architect at AHCCCS. ‘In just a few weeks, we’ve given our Medicaid recipients the ability to manage many of their own records through our MyAHCCCS.com Web portal, and we’ve enabled hospital personnel across the state to perform online registration of Medicaid-eligible newborns and ensure immediate coverage. Both solutions have reduced workloads and improved staff productivity at our call center. But by far the biggest benefit of HostBridge is that we can leverage our legacy business logic without incurring the high costs associated with changing mainframe code.
Challenge
AHCCCS relies on a call center staff of 100 for much of its communication with clients and health care professionals. Historically, only call center staff could access data and applications on the organization’s IBM z/OS mainframe to update records and answer questions from Medicaid recipients or health care providers. AHCCCS realized that if it could provide its users with access to its legacy systems, even on a limited basis, it could reduce call center dependence, assign staff to new duties, and increase productivity. HostBridge helped AHCCCS achieve those goals quickly and easily.
Technical Requirements
Having rewritten mainframe code in the past, AHCCCS knew it needed an integration solution that would leverage existing business logic without changing its programs developed using CA Ideal.
• No changes to critical legacy applications. AHCCCS’s previous code rewrite created a cascade of issues, and maintenance problems crop up to this day. Avoiding another code rewrite was a top priority.
• CA Ideal support. AHCCCS’s Web-integration solution also had to support the CA Ideal presentation layer.
• No screen scraping. In CA Ideal applications, the screen coordinates of fields often change; AHCCCS needed a solution that would identify screens not by coordinates but by field names.
Solution
AHCCCS chose HostBridge to meet both its technical and business requirements. HostBridge is mainframe software that runs under CICS. Supporting CA Ideal applications, it SOA-enables CA Ideal transactions for presentation via the Web. AHCCCS evaluated its call types and volumes, then turned to HostBridge to deliver Web-based access initially to Medicaid recipient records and newborn registration. Further implementations are in development or planning.
Through the MyAHCCCS.com Web portal, any Medicaid recipient with Internet access ‘ at home, a library, or elsewhere ‘ can now set up an account and access selected mainframe-based records through a user-friendly Web front end, without involving call center personnel. Clients now verify their eligibility; enroll in plans such as Behavioral Health and Medicare, including Part D prescription drug plans; and view, maintain, and update personal records. Thanks to HostBridge, mainframe applications are integrated into MyAHCCCS.com for the first time.
Figure1. Arizona Health Care Cost Containment System architecture
HostBridge also enabled AHCCCS to connect the health care community directly to mainframe resources and eliminate the call-center middleman. Anytime a Medicaid-recipient mother gives birth, the baby is automatically covered by Medicaid but must be registered to receive benefits. A new online enrollment system allows hospital staff to register newborns, day or night, by filling out a simple Web form integrated with the AHCCCS mainframe.
Further out on the horizon is a broad-based health information exchange, or HIE. As a statewide provider, AHCCCS is well positioned to act as an information hub, pulling data from hospitals, clinics, pharmacies, laboratories, and other providers, as well as its own systems; integrating that data through a Web services architecture; and providing data services back to the health care community.
Benefits
The first two Web applications implemented with HostBridge already show promising results. AHCCCS has found that HostBridge simplicity enables rapid turnaround of new integrations. In fact, more time is spent analyzing the logic of legacy applications than Web-enabling them with HostBridge.
While it’s too soon to define its ROI in hard dollars, AHCCCS has seen improved access to data and productivity gains. Over 1,200 Medicaid recipients signed up to access their personal records within three weeks of golive, and call center staff have already asked AHCCCS to extend more legacy data to the Web. For AHCCCS the bottom line is the ability to provide easier, more productive access to critical business applications.
