Exchange and Medicaid IT System Contracts
Know of something we should add to this compilation? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment below, or email the author with your suggestion. He can be reached at scott.keays@umassmed.edu.
| State | Exchange Type | System Procurement Status1 | System Vendor and Role2 | System Software Components and Platforms Vendors3 | Additional Information |
|---|---|---|---|---|---|
| AK | Defaulting to a Federally Facilitated Exchange | Contract In PlaceEligibility Information System Replacement Project | Deloitte (System Integrator)State Staff (Program Management) | ||
| AL | Defaulting to a Federally Facilitated Exchange | Contract In PlaceMedicaid Eligibility Determination System |
State Staff – DPH (System Integrator)Hewlett Packard (Developer) SLI (IV&V and QA) Software AG (Eligibility Determination System) |
InRule (Rules Engine) | |
| AR | Conditionally Approved State Partnership Exchange | Contract In PlaceArkansas Medicaid Enterprise (AME) MMIS Core System and Services | State Staff (System Integrator) | CAIEngage Point eSystems Inc. Northrop Grumman Red Mane |
|
| AZ | Defaulting to a Federally Facilitated Exchange | Contract In PlaceEligibility System Modernization | Social Interest Solutions (System Integrator and Developer)netlogx (IV&V) | Xerox (IT Platform)Social Interest Solutions/Microsoft Platform (Eligibility System) | |
|
CA
|
Conditionally Approved State Based Exchange
|
Contract In PlaceEligibility, Enrollment and Retention System | Accenture (System Integrator)CGI (Developer) First Data Government Solutions (Project Management) Visionary Integration Professionals (VIP) (IV&V) |
Accenture Public Service PlatformAccenture Health Benefits Exchange Getinsured Oracle Policy Automation (Rules Engine) Pinnacle (SHOP) |
|
| CO | Conditionally Approved State Based Exchange | Contract In Place | CGI (System Integrator)Deloitte (Developer) First Data (IV&V) State Staff (Program Management) |
Corticon (Rules Engine)hCentive (Eligibility & Enrollment, Employee Portal, Broker/Navigator Portal, Employer Portal, and Carrier Portal) Healthation (Financial Management) North Highland (Project Management Office) Vangent |
In 2012, the Colorado Medicaid program procured a commercial off-the-shelf (COTS) rules engine and will continue to work with their existing Medicaid system vendor (Deloitte) to configure its system |
| CT | Conditionally Approved State Based Exchange | Contract In PlaceBusiness Process and IT Operations | Deloitte (System Integrator and Developer)KPMG (Project Management) | Corticon (Rules Engine) | |
| DC | Conditionally Approved State Based Exchange | Contract In PlaceHealth Benefit Exchange and Integrated Eligibility System | Infosys (System Integrator)In House (Program Management) | IBM/Curam (Rules Engine) | |
| DE | Conditionally Approved State Partnership Exchange | Sole Source | Deloitte (System Integrator and Developer)IBM (Program Management) | Corticon (Rules Engine) | |
| FL | Defaulting to a Federally Facilitated Exchange | Contract In Place | Deloitte (System Integrator)North Highland (Program Management) | ||
| GA | Defaulting to a Federally Facilitated Exchange | In ProcurementIntegrated Eligibility System | Public Consulting Group (IV&V) | ||
| HI | Conditionally Approved State Based Exchange | Contract In PlaceHealth Insurance Exchange Implementation Project | CGI (System Integrator and Developer)KPMG (Integrated Eligibility System) Public Consulting Group (Project Management Office) |
Oracle Policy Automation (Rules Engine)Exeter One Gate (COTS Vendor) eWorld (Local IT resources) |
IV&V vendor in procurement |
| IA | Conditionally Approved State Partnership Exchange | Contract In PlaceIowa Integrated Eligibility Project | Accenture (Integrated Eligibility Systems Integrator)Public Consulting Group (IV&V) SLI (QA and Management Services) CSC Government Solutions (Program Management) |
Oracle Policy Automation (Rules Engine)Accenture Cognosante |
|
| ID | Conditionally Approved State Based Exchange | Contracts in Place | State Staff (Developer, QA, IV&V, and Program Management)GetInsured (Technology Platform) Acenture (Project Management) |
Oracle Policy Automation (Rules Engine) | |
| IL | Conditionally Approved State Partnership Exchange | Contract In PlaceIntegrated Eligibility System | Deloitte (System Integrator and Developer)State Staff (Program Management) Health Management Associates (Sub Contractor) CSG Government Solutions (Project Management – Eligibility system) First Data (Design Management – Exchange system) |
Corticin (Rules Engine) | IV&V vendor in procurement |
| IN | Defaulting to a Federally Facilitated Exchange | Contract In PlaceIndiana Eligiblity Determination Services System | Deloitte (System Integrator and Developer)RAND Corporation (Sub Contractor) State Staff (Program Management) |
Corticon, Curam (Rules Engine) | |
| KS | Defaulting to a Federally Facilitated Exchange | Contract In PlaceEligibility and Enforcement System | Accenture (Integrated Eligbility Systems Integrator)Service Engineering Services (IV&V) State Staff (Program Management) |
Accenture Public Service Platform (APSP)Accenture Citizen Self-Service Portal Accenture Benefits Management System Oracle Policy Automation (Rules Engine) |
|
| KY | Conditionally Approved State Based Exchange | Contract In PlaceHealth Benefit Exchange | Deloitte (System Integrator and Developer)In House(Program Management) |
Corticon (Rules Engine)hCentive (Individual Shopping & Comparison, Employee Shopping & Comparison, and Employer Portal) Microsoft.net |
|
| LA | Defaulting to a Federally Facilitated Exchange | In ProcurementMedicaid Eligibility Data Systems IT Architecture Upgrade |
In House (Developer) | InRule (Rules Engine)Microsoft.net | IV&V contract in procurement |
| MA | Conditionally Approved State Based Exchange | Contract In PlaceHealth Insurance Exchange and Integrated Eligibility System | CGI (System Integrator and Developer)Deloitte (Sub Contractor) BerryDunn (IV&V) UMass Medical School (Project Management) |
Oracle Policy Automation (Rules Engine)Atlassian, Bonfire, Fisheye, IBM, Justinmind, and Micro Focus | |
| MD | Conditionally Approved State Based Exchange | Contract In PlaceHealth Benefit Exchange, Core Functionality and MAGI Determination (Phase 1A) | Noridian (System Integrator)BerryDunn (IV&V) Engagepoint (Sub Contractor) |
Curam (Rules Engine)Connecture (Plan Management, Financial Management, Enrollment, SHOP, Agent Management) EXACT (Service Oriented Architecture (SOA) platform – Noridian) OnBase (Document Management) |
|
| ME | Defaulting to a Federally Facilitated Exchange | In Procurement | KPMG (Program Management) | ||
|
MI
|
Conditionally Approved State Partnership Exchange
|
Contract In Place Medicaid Eligibility and Enrollment | CGI | Oracle Policy Automation (Rules Engine) | |
| MN | Conditionally Approved State Based Exchange | Contract In Place | Maximus (System Integrator)State Staff (Program Management) | Curam (Rules Engine)Connecture (Enrollment/Plan Management/SHOP) EngagePoint (Financial Management) |
IV&V contract in procurement |
| MO | Defaulting to a Federally Facilitated Exchange | EngagePoint (System Integrator)Berry Dunn (IV&V Services) | |||
| MS | Defaulting to a Federally Facilitated Exchange | In Procurement Exchange Portal Phase 1, Exchange Phase 2 & 3 | Xerox (Non-ACA work) | ||
| MT | Defaulting to a Federally Facilitated Exchange | Deloitte (Non ACA Modernization)Northrup Grumman (Developer) | IBM WODM/Jrules (Rules Engine) | ||
| NC | Defaulting to a Federally Facilitated Exchange | Sole Source | Accenture (Integrated Eligibility Systems Integrator)IBM/Curam (Developer) Maximus (IV&V) |
IBM/Curam (Eligibility) | |
| ND | Defaulting to a Federally Facilitated Exchange | No ProcurementEligibility System Modernization Project | State Staff (Developer and Program Management) | FICO Blaze Advisor (Rules Engine) | |
| NE | Defaulting to a Federally Facilitated Exchange | TBDIn House (Developer) | Navigant, Health Management Associates, Miliman, Mercer, and Public Consulting Group (Sub Contractors) | ||
| NH | Conditionally approved State Partnership Exchange | Medicaid Eligibility and Enrollment System | Deloitte (System Integrator, Developer, and Program Management) | IBM/WODM (Rules Engine) | |
| NJ | Defaulting to a Federally Facilitated Exchange | Procurement PlannedMedicaid Management Information System | Hewlett Packard (System Integrator) | IBM/Curam (Rules Engine) | |
| NM | Conditionally Approved State Based Exchange | In ProcurementInformation Technology and Integrated Services | Deloitte (System Integrator, Developer, and Program Management)GetInsured (Web-portal) Cognosante (IV&V) |
Corticon (Rules Engine)Microsoft.net | Deloitte is the Systems Integrator for the Integrated System Delivery Replacement Project; which will will seamlessly interface with New Mexico Health Insurance Exchange. |
| NV | Conditionally Approved State Based Exchange | Contract In PlaceHealth Care Reform Eligibility Engine | Xerox (Business Operation Services)Deliotte (Eligibility and Enrollment) Public Consulting Group (IV&V) |
ILOG/WODM (Rules Engine) | |
|
NY
|
Conditionally Approved State Based Exchange | Contract In PlaceHealth Benefit Exchange | CSC (System Integrator and Program Management)Maximus (Interfaces) Cognosante (IV&V and QA) |
Oracle Policy Automation (Rules Engine)Social Interest Solutions (SMEs) hCentive (Eligibility & Enrollment, Employee Portal, Employer Portal, Broker/Navigator Portal) SERFF (Plan Management) |
|
| OH | Defaulting to a Federally Facilitated Exchange | Contract In PlaceIntegrated Eligibility System | Accenture (Integrated Eligibility Systems Integrator)Gartner Consulting, Mercer (Sub Contractors) | ||
| OK | Defaulting to a Federally Faciliated Exchange | Contract In PlaceMedicaid Eligibility and Enrollment System | Hewlett Packard (System Integrator, Developer, and Program Management)Cognosante (IV&V) | InRule (Rules Engine) | |
|
OR
|
Conditionally Approved State Based Exchange
|
Sole Source Procurement | Oracle (Tool Configuration, Implementation, and Environment Hosting)Cognosante (External Interfaces Development) Deloitte (User Interface) Maximus (IV&V) |
Oracle Policy Automation (Rules Engine) | |
| PA | Defaulting to a Federally Facilitated Exchange | Contract In Place Medicaid Eligiblity and Enrollment System | Deloitte (Systems Integrator)KPMG (IT support) | Corticon (Rules Engine)Microsoft.net | |
| RI | Conditionally Approved State Based Exchange | Contract In PlaceUnified Health Infrastructure Project | Deloitte (Systems Integrator, Developer, and QA)Public Consulting Group (PMO for Medicaid and Human Services) Wakely/KPMG (PMO/TA for Exchange) |
Oracle Policy Automation (Rules Engine) | IV&V contract in procurement |
| SC | Defaulting to a Federally Facilitated Exchange | Medicaid Eligiblity and Enrollment System | Clemson University (System Integrator)State Staff (Developer) | IBM/Curam (Rules Engine) | |
| SD | Defaulting to a Federally Facilitated Exchange | Contract In PlaceMedicaid Eligiblity and Enrollment System | Deloitte (System Integrator) | ||
| TN | Defaulting to a Federally Facilitated Exchange | Contract In PlaceMedicaid Eligiblity and Enrollment System | Northrup Grumman (System Integrator) | ||
| TX | Defaulting to a Federally Facilitated Exchange | Contract In PlaceMedicaid Eligiblity and Enrollment System | Deloitte (System Integrator)GreenTree Group (IV&V) | TIERS (Rules Engine) | |
| UT | Pursuing a State Partnership Exchange | Avenue H (Small Business Exchange) | State Staff (System Integrator and Developer) bswift (Shopping and enrollment) |
Drools (Rules Engine) | |
|
VA
|
Defaulting to a Federally Facilitated Exchange
|
Medicaid Eligiblity and Enrollment System | Deloitte (System Integrator) | ILOG (Rules Engine) | |
| VT | Conditionally Approved State Based Exchange | Contract In PlaceIntegrated Eligibility Solution | CGI (System Integrator and Developer)Gartner (IV&V) Desai Consulting (Program Management) |
Oracle Policy Automation (Rules Engine)Exeter One Gate (COTS Vendor) |
|
| WA | Conditionally Approved State Based Exchange | Contract In PlaceHealth Benefits (Insurance) Exchange System Integrator Services | Deloitte (System Integrator)IBM (Developer) Bluecrain (QA) Eclipse Solutions, Inc. (IV&V) Treinen (Program Management) Cambria, TSG (Sub Contractors) |
Oracle Policy Automation (Rules Engine – Exchange), IBM iLog (Rules Engine-Eligibility and Enrollment) | |
| WI | Defaulting to a Federally Facilitated Exchange | Medicaid Eligiblity and Enrollment System | Deloitte (System Integrator and Developer) | Corticon (Rules Engine) | |
| WV | Conditionally Approved State Partnership Exchange | Medicaid Eligiblity and Enrollment System | Deloitte (System Integrator)WV OIT (IV&V services) WV BMS (Project Management) BerryDunn (Project Support Services) | Corticon (Rules Engine) | |
| WY | Defaulting to a Federally Facilitated Exchange | Medicaid Eligiblity and Enrollment System | Verticale Build (System Integrator)Northrup Grumman (Developer) Public Knowledge (IV&V) State Staff (Program Management) |
iLog/JRules (Rules Engine) | |
Notes
1 Procurement Planned, In Procurement, Contract in Place.
2 Notes role each vendor procured is playing.
3 Notes the software or hardware being used in each state’s solution.
Produced by Scott Keays, Office of Health Policy and Technology at UMass Medical School
Related categories:
– See more at: https://www.statereforum.org/medicaid-exchange-it-contracts#sthash.R1McGQjp.dpuf
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
