Unified Customer Experience in New York

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As part of the state’s ambitious reinvention of its healthcare system, Maximus worked with New York to integrate eligibility and
enrollment across 100+ plans statewide — including Medicaid, CHIP, and the individual marketplace. As a result, we have created a consumer-centric, analytics-driven experience that ensures “no wrong door” for a wide range of customers.

Image of a stylish elderly man smiling and answering phone call while sitting at desk in cozy workplace at home

Services provided

  • Creating and administering seamless, integrated customer support
  • Using innovative technology infrastructure across programs
  • Adapting to major changes such as the ACA
  • Handling a surge in beneficiaries while mitigating cost pressures
  • Augmenting the state workforce

Success achieved

  • 6 million beneficiaries served annually
  • 4.5 million calls handled in 2020
  • 1/3 less cost to operate contact centers

Using innovative technology infrastructure across programs

Challenge

The huge administrative costs of healthcare can create significant gaps in state budgets. The cost of New York’s Medicaid program, the nation’s largest, had swollen to 32%, posing a significant risk of bankruptcy for the state. New York was in need of a solution to close budget, staffing, and technology gaps by helping the state to make sustainable reforms to Medicaid and other healthcare programs.

Approach

Maximus worked with the state to create and administer seamless, integrated customer support, which means “no wrong door” or single point of entry for enrolling all eligible citizens in public health programs. Using innovative technology infrastructure across programs and adapting to major changes such as the ACA and handling surges in beneficiaries while mitigating cost pressures.

We worked to help augment the state workforce, alleviating administrative burdens while freeing employees to focus on more complex or impactful work.

Results

By taking over responsibility for — and consolidating — most citizen-facing services, we’ve enabled New York to focus its resources on improving efficiency and care. In fact, with Maximus leading the way, New York was one of the first states to successfully implement a “single point of entry” model for consumers seeking public health insurance.