RedMane uses Time Machine® to Streamline Puerto Rico Department of Health's Medicaid Eligibility Modernization

Submitted by Kathy on Tue, 2024-10-01 21:14

Tuesday, October 1, 2024at 12:00 PM EDT

Topic:

Puerto Rico recognized an opportunity to modernize its Medicaid eligibility and enrollment process given that roughly half of the island's 1.6 million citizens are enrolled in Medicaid and that storm recovery activities are still ongoing. On the significant project, RedMane is collaborating with the Puerto Rico Department of Health. A new Medicaid system serves as the transformation's main tenet. RedMane employed its Smart Transfer strategy with an eye toward outcomes, quality, and timeliness. This novel approach builds on the IBM Social Program Management platform, commonly known as Curam Software, and makes use of the work done by RedMane for a range of clients. The project name is Medit3g and its’s main goal is to determine eligibility and handle claims integrated back into Puerto Rico System.

Challenge:

RedMane one of the major challenges was testing all the date and time-sensitive events in the social management system. Time travel testing is used to simulate the eligibility and enrollment life cycle of Medicaid cases. For example, initial application, change of circumstance, renewals, and end of certification periods.

  • A family applies for Medicaid, and then 6 months later have an increase in income. How does this affect each member’s eligibility?
  • A woman turns 65 8 months after her initial application. How does this affect her eligibility?
  • A 28-year-old man marries a woman, with a child, and then she becomes pregnant. How does this affect her eligibility?
  • The public health emergency ends 4 months from now. How does this affect everyone’s eligibility (various people at different phases of eligibility and in different programs)

The Technical Environment:

RedMane is bringing change in the deployment process by using Agile Framework. There is new Release Every Two weeks in SIT and UAT environment. Typical environment involved WebSphere, IHS, DB2 database, Azure cloud and custom java application.

RedMane is also a leading-edge organization, and is an excellent example of cloud transformation, navigating a complex technical environment while utilizing the best in architecture. With an Agile/SCRUM methodology, CI/CD is in play with Development Operations allowing for a flexible yet consistent method overall.

The Time Machine Solution:

RedMane enviroments involve cloud-native and agile frameworks. Time Machine’s virtual clock enables them to time travel freely without resources sitting idle and breaking test automation. It also empowers self-service and test automation to further boost productivity. Time Machine enables self-service which means users are able to assign virtual clocks by themselves without the need to wait for the infrastructure team to shut down & restart the application & database and change the system clocks. Redmane has successfully implemented Curam with Time Machine for Medicare Integrated eligibility for the State of Missouri for multiple years now.  So it is natural for Redmane to select Time Machine as the enabler for time travel testing and testing automation.

"At least 50% of our testing at any given time requires time travel testing.  Time Machine is used on the daily basis.  Without it, there is no way that we could deliver the project on time!”  Said Jon Hunt, IT Consultant of RedMane.

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About Redmane:

RedMane provides software solutions and systems integration services that address complex real-world challenges. RedMane has a people-centric approach where all the processes result in best possible solution. Adult protection, child welfare, child support, benefit eligibility, and enterprise case management are among the human services specialties of the company. RedMane takes pride in creating technologies around people and solving the most challenging problems. RedMane was established in 2000 and their headquarters is in Chicago, Illinois.

About Puerto Rico Department of Health:

The Puerto Rico Department of Health is the cabinet-level agency created by the constitution of Puerto Rico.   Puerto Rico Department of Health is led by the Secretary of health. It is responsible for the implementation of different programs such as Nutrition policy and promotion, Medicaid Integrated eligibility program, Enrollment Solution, and Food safety & distribution. The Puerto Rico Department of Health’s Medicaid Program operates 66 local offices, employs over 800 staff, and uses a managed care approach for healthcare service delivery

About Time Machine:

Software Virtual Clocks for Time Travel Testing. Simulate past and future dates effortlessly with Time Machine®, enabling comprehensive testing of your date- and time-sensitive applications. Ideal for validating critical business processes like quarter-end and year-end processing, billing cycles, regulatory compliance (including Year 2038), and policy lifecycles during integration, upgrades, virtualization, cloud migration, and containerization. Eliminate the risks and downtime associated with system clock resets in complex environments like Active Directory and Kerberos.

About Solution-Soft:

The Leader in Virtual Clock and Time Travel Testing Solutions

Since 1997, Solution-Soft has been at the forefront of virtual clock software and time travel testing solutions, empowering organizations in the ever-evolving digital world. Our flagship product, Time Machine, has revolutionized application testing, enabling thousands of companies, including 47 of the Fortune 100 US companies, to reduce costs and accelerate project delivery by an average of 3 – 10 times across traditional systems and containerized applications.

The Time Machine Product Suite extends these capabilities, optimizing cloud migration, test automation, Agile/DevOps, and containerization testing. Our latest innovation, Time Machine for Containers, supports standalone Docker containers and large-scale Kubernetes and OpenShift clusters (including a 16,000+ CPU core, 1,300+ namespace deployments).

Trusted by over 2,000 customers worldwide across diverse industries (including 3M, AMEX, BBC, Boeing, and more) and partnered with industry leaders like Accenture, IBM, Microsoft, Oracle, and Red Hat, Solution-Soft, founded in 1993 and headquartered in Santa Clara, CA, provides cutting-edge solutions for your time-sensitive testing needs. Learn more at www.solution-soft.com or call +1.408.346.1400.

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