Client Story

Caring for the most vulnerable population

KPMG helped the State of Tennessee modernize its IT system for Medicaid.

Andrew Gottschalk

Andrew Gottschalk

Partner, Health & Government Solutions, KPMG US

+1 312-665-2883

Client
State of Tennessee
Sector
State and local government
Project
Medicaid IT system modernization
  • Client challenge
  • Benefits to client
  • Approach
  • KPMG insights

Client challenge

The State of Tennessee’s Division of TennCare (TennCare) was tasked with modernizing the state Medicaid IT system, a vital source of health care services for approximately 1.4 million residents, often considered the most vulnerable population of the state as of September 2019. Previous attempts at modernization had not been successful. Although systems integrators were engaged to support the deployment of a new software environment, the state also recognized the need for a long-term strategic technical advisor to coordinate, assess, and manage everyone’s efforts along the transformation journey.

Benefits to client

Since September 2015, KPMG has been advising the State of Tennessee’s Division of TennCare through their transformational journey, focused on modernizing their Medicaid program and assisting with its eligibility and enrollment system implementation. As one of the main priorities of TennCare, the KPMG team supported the successful deployment of the modernized eligibility system in March 2019. Throughout the course of the project, the KPMG team established a business analyst function; developed a roadmap for projects in scope; developed business process models and detailed requirements; delivered funding, certification, and procurement support; launched an organizational change management initiative, supported training and testing programs, and provided quality assurance over the system integrator.

Approach

Over the years, KPMG has served the State of Tennessee’s Division of TennCare as a trusted, strategic advisor. Subsequently, KPMG was directly engaged by the state to provide technical advisory and assessment services for modernizing its Medicaid eligibility system. The current project is very complex and involves the medical assistance eligibility and enrollment systems, the Medicaid management information system and appeals system, the health information exchange, and components for analytics and security. KPMG assembled an experienced, multidisciplinary team that now works closely with third-party systems integrators and stakeholders in the Division of TennCare and provides a number of services to help support the success of the project.

KPMG insights

Work with industry specialists

Projects for the public sector can have unique requirements in terms of size, complexity, funding, security, and regulatory mandates. Specialists in state and local government understand the public sector and can speak its language, helping government entities address their specific challenges.

Leverage previous efforts

For the Tennessee project, KPMG leveraged portions of existing operating models and tested methodologies developed for engagements in other states involving healthcare delivery systems. This helped ensure steady progress along the transformation journey from strategy to implementation.

Build multidisciplinary teams

Today’s large-scale projects need a flexible approach involving people, processes, and technology. Members with diverse skills can complement each other and optimize the team’s overall efforts.

As a long-time trusted advisor to this client, KPMG helped ensure steady progress along the transformation journey from strategy to implementation.

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