Establishing A Public Health Insurance Exchange

In 2011, First Data was contracted by the State of New York to support the establishment of a public Health Insurance Exchange that would provide a competitive marketplace for individuals and small employers to directly compare available private health insurance options. Xentity worked as a subcontractor under First Data to complete this project.

Redesigning To Reflect New Requirements and Cost-Efficiency

This project considered two factors. First, the Office of Temporary and Disability Assistance (OTDA) team brought valuable insight and knowledge to the table stemming from their management of the WMS systems and subsystems, as well as systems consumer-centric solutions like myBenefits and myWorkspace. The OTDA’s experience developing the Functional Road Map (FRM) was also important as a major agency, as it was a multi-year undertaking to map the current systems and practices. Much of the OTDA’s work needed to be re-cast to reflect the requirements of the Affordable Care Act (ACA) and the Early Innovators solution. Furthermore, there was also foundational work that could be used to derive use cases, process flows, workflows and other considerations that can accelerate the work that needs to be done for the Exchange.

Second, The FRM project was known as “On the Road Again”, a collaborative effort among the OTDA, Office of Children and Family Services (OCFS), Department of Health (DOH), and local Department of Social Services (DSS)agencies.  The FRM Project needed updates to the business and information requirements. This was to provide a single statewide integrated view of client information. The modernization goal was to support cost-efficient and outcome-focused service delivery to our customers.

Strong Consultation and Analysis Support

Xentity provided an on-site team in Albany, NY Consultant and Analyst Support for the State of New York HealthCare Insurance Exchange System and Data Development. Tasks included supporting Data Architecture, Data Warehouse Design, Business Process Re-engineering, and overall Enterprise Architecture, and Solutions Architecture Activities. Also included were analysis support and architecture on health systems. Also, processing in support of implementing the insurance exchange/marketplace.

“Empowering Health and Human Services Transformation through people, processes and technology”. That was the guiding principle of this collaborative effort among OTDA, OCFS, DOH, and Local Departments of Social Services (LDSS). The transformation empowered State and local agencies to shift into an innovative era of benefits and services delivery. The overall goal was to create efficiencies. They met this goal through developing new and refined business processes. Innovative technology from each of the participating agencies supported this effort. A series of short and long term strategies that meet enterprise-wide needs and Federal requirements helped realize this transformation. 

A New System Supporting Millions

Through the efforts of First Data and Xentity, the state of New York realized its goals and transformations. As of January 2016, the system has supported more than 2.7 million enroll QHPs with New York State of Health. We at Xentity are passionate about using data to make a difference, rather than creating new technologies. It was an honor to play a part in this process.