P&P August 2015

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By Mark Allen

How Technology Can Impact Health and Human Services

T he passage of the Affordable Care Act (ACA) shifted more respon- sibility for the delivery of benefits in health and human service programs to the states. The momentum of the ACA and programs like the A-87 exception prompted many states to modernize the administration of public assistance programs to enhance customer service for applicants and recipients and to remain compliant with the updated legislation. These initiatives have resulted in improvements to program integrity, integration with other health and human service programs, and ultimately provide better services to citizens. The ACA put the wheels of change in motion, and now, with unprecedented innovations taking place in technology, health and human service managers and administrators are in a unique position to advance their organizations’ mission while con- tinuing to improve operations. nology is that proper application can address both mission advancement and business efficiency. Those managing health and human service agencies must consider both when making infra- structure decisions. The decision does not have to be an all or nothing proposi- tion, but it should be one that results in positive impacts and gains in the short term, and has increasing poten- tial to improve business processes and customer services over the long term. The short-term goal for many health and human service agencies remains in the need to streamline enrollment and eligibility processing. This requires reengineering and automating legacy Advancing the Mission While Improving Business Efficiency The beauty of innovative tech-

and/or paper-based systems, with the goal of readily guiding citizens and providers to what they need, when they need it. With intense decision-making driving these processes, automating business decisions is a critical means to achieving both short-term and long- term goals. This is where a business rules management system (BRMS) can help. The Benefits of Adopting a BRMS The effective management and auto- mation of business rules provides a number of valuable benefits to health and human service organizations. A BRMS can decrease costs, improve compliance, and provide a better citizen experience. These systems can help your organization make better and faster decisions, and be agile enough to rapidly adapt to changing rules and regulations. These systems help you:

Keep up with the pace of change. With IT backlogs of change requests that may take months to deliver, a BRMS helps change business logic in hours not months. Improve efficiency and produc- tivity. A BRMS helps to automate recurring decisions that are governed by policy and guidelines, significantly reducing the need for manual interven- tion and processing. Ensure compliance. A BRMS helps capture policy and regulation in the form of business rules that are enforced automatically with each transaction. And every decision in the BRMS provides an audit trail. Improve citizen service. A BRMS helps provide more responsive expe- rience to citizens, serving as the backbone to deliver a modern and powerful self-service experience.

See BRMS on page 34

Illustration by Chris Campbell

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Policy&Practice   August 2015