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Policy&Practice
August 2016
34
technology
speaks
By Kristen Duus
Uncovering Oregon’s Path to Integrated Eligibility
T
here was no fanfare. There were
no reporters. There were no
cameras or media.
It was almost as though the day had
come and gone and no one noticed.
For Oregon, Dec. 15, 2015 marked
the first step to uncovering the state’s
path to integrated eligibility. On this
rainy, grey December day, the state’s
Medicaid agency, the Oregon Health
Authority (OHA), launched its new
eligibility system known as Oregon
Eligibility, or “ONE.”
Only two years before, Oregon was
in the national spotlight for the failed
launch of Cover Oregon, the state-
based health insurance exchange.
While still embroiled in legal battles
over the failure, in November 2014
Oregon shifted to Healthcare.gov—the
federally facilitated marketplace, and
almost simultaneously launched the
16-month Modified Adjusted Gross
Income (MAGI) Medicaid system
transfer project to implement ONE.
ONE would bring to Oregon a web-
based, state-of-the-art worker portal
for workers to determine real-time
eligibility for adults who qualify for
Medicaid due to income level—a new
population eligible as a result of the
Affordable Care Act. A self-service
applicant portal launched in February
2016, enabling community partners to
help Oregonians submit applications
and report changes.
Challenged by Oregon’s tainted repu-
tation for delivering IT projects, ONE
would face political hurdles during
implementation, and was affected
by the change in several key Oregon
leadership positions. These changes
in leadership included the governor,
state Medicaid director, director at
the state’s Data Center, and the OHA
director.
How did Oregon successfully launch
ONE despite these challenges? Here
are 10 factors contributing to our
success:
1. We transferred an existing system.
Oregon transferred and imple-
mented “kynect,” Kentucky’s system.
We chose this system because of the
similar Medicaid rules, policies, and
system interfaces, and the system
closely matched Oregon’s needs.
2. We hired a systems integrator.
Oregon procured Deloitte Consulting
for systems integration services.
Deloitte successfully implemented
integrated eligibility systems in 23
other states, including the original
Kentucky system.
3. We followed project management
practices. The business and stake-
holder community, technology staff,
and consultants strongly supported
the use of sound project manage-
ment techniques and processes.
4. We managed scope tightly. Oregon
chose to change policy or business
process before technology, when
feasible. This principle drove
adoption of best-practice business
processes already inherent in kynect.
5. We established project governance.
An executive steering committee
was formed to oversee project imple-
mentation. Voting members included
the agency director, chief financial
officer, chief information officer,
state Medicaid director, and external
advisors from the Office of the State
Chief Information Officer (CIO),
Legislative Fiscal Office, and other
state agencies.
6. We embraced the State “Stage Gate”
process. The project was overseen
jointly by the Office of the State CIO
and the Legislative Fiscal Office. The
Stage Gate process helped the project
to reduce risk and ensure readiness.
7. We focused on communication.
Communication specialists deliv-
ered regular messages to staff and
See Oregon on page 46
Photo illustration by Chris Campbell