Ohio Benefits

Health Transformation and Integrated Eligibility

Advocate was selected by the Ohio Governor’s Office of Health Transformation to plan, initiate, and manage an eligibility modernization project to simplify client eligibility based on income, streamline state and local responsibility for eligibility determination, and modernize eligibility systems technology.

Key goals and initiatives for the project included:

  • Redesign business processes to enable offices to gain greater efficiencies
  • Support Medicaid-eligible citizens of Ohio
  • Integrate eligibility across agencies and simplify eligibility following the new guidelines through automated technology processes
  • Improve the efficiency of state and local services
  • Optimize technology used by the Health and Human Services agencies

Advocate was instrumental in assisting with the strategic planning, requirements gathering, solicitation support, and program management aspects of the program. Advocate implemented longstanding proven practices to successfully plan and execute the project and provided seasoned staff to manage the effort including performing key tasks such as:

  • Program planning & management
  • Requirements elicitation and validation
  • RFP development, publication, scoring criteria development, evaluation, contract statement of work development and negotiations
  • Process (workflow) analysis, data analysis and Organizational Change Management oversight
  • Systems review, analysis, and assessment

As a result of our efforts over 936,000 cases have been submitted through Ohio Benefits with approximately 820,000 individuals enrolled in Medicaid and 1.3 million individuals have been converted from the legacy system.