Tag: Medicaid

Beginning on April 1, 2023, state Medicaid agencies (SMA) will have one year to “unwind” temporary COVID-era changes and return to pre-pandemic ways of working. A major part of that will be re-verifying that all 91 million members still qualify to receive Medicaid benefits. For nearly a year, AWS has supported SMAs with in-house Medicaid expertise to identify unwinding issues and develop solutions to address them. The top four concerns that SMAs have shared are in approaching outreach and engagement, staffing shortages, returned mail, and reporting capabilities. Learn how AWS can help states across the country overcome these challenges across different scenarios.

A key focus for the Department of Health and Human Services (HHS) and state Medicaid agencies is making sure those eligible for Medicaid maintain coverage and supporting transition to alternatives. Medicaid agencies need to conduct outreach to make their millions of members aware of the process for redetermination. With cloud-based tools from AWS, state agencies can conduct this outreach using no code/low code, serverless, elastic services that can scale to two billion text messages a day. In this blog post, learn how to set up a multi-lingual, interactive SMS message campaign that can automatically verify and update member information on file based on member responses.

To mitigate synthetic fraud, government agencies should consider complementing their rules-based improper payment detection systems with machine learning (ML) techniques. By using ML on a large number of disparate but related data sources, including social media, agencies can formulate a more comprehensive risk score for each individual or transaction to help investigators identify improper payments efficiently. In this blog post, we provide a foundational reference architecture for an ML-powered improper payment detection solution using AWS ML services.

In this blog post, the Georgia Department of Community Health (DCH) chief information officer, Venu Gurram, describes his experience transforming their Medicaid Management Information System (MMIS) from legacy on-premises infrastructure to a collection of services in the cloud. Learn how the DCH joined forces with another state entity, the Georgia Tech Research Institute (GTRI), to use the Amazon Web Services (AWS) Cloud to deliver the next generation of Medicaid technology: a Medicaid Enterprise System (MES).

Health and Human Services (HHS) agencies collect an endless amount of data that, however abundant, often fails to paint the whole picture. According to NextGov, 74 million Medicaid records are now hosted in the AWS Cloud. The Centers for Medicare & Medicaid Services (CMS) is porting in five years or more of records from 50 states—totaling 72 […]