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We Want You to Help Design the Next Generation of Medicaid Management Systems

Which would you prefer? A software product that makes assumptions about your needs and remains relatively closed to new advances in technology, or one that was created with your unique problems in mind and remains open to new innovations?

It’s an easy choice. Yet, many software products are still developed the first way, and often fall short for that reason.

As we work to modernize and improve Medicaid management systems, we also need to update our ways of thinking about system design. It’s time to adopt the philosophy of design thinking, which takes an empathetic, human-centered approach to software development.

Putting the Focus on Client Needs

In the past, software companies would plan every detail of a system’s architecture before development even started — often without considering who may be using the technology and how their needs may vary. This led to products that failed to meet user expectations and were sometimes outdated the moment they were introduced. As new technologies emerged, features were simply grafted onto legacy systems, creating integration challenges and degrading the user experience.

Design thinking upends the old way of software development by directly involving the technology’s users in the process. In the context of health and human services — and Medicaid, specifically — that can mean anyone who actively uses Medicaid management systems, from government employees to providers to beneficiaries.

Better Experiences, Better Outcomes

By directly engaging clients in the process, design thinking allows us to be more agile, open and user-focused in the way we create Medicaid management systems.

Instead of planning every detail of systems up front, there are big advantages to creating a minimum viable product, and then quickly creating new iterations as we receive feedback and input from those interacting with the technology on a daily basis. That way, systems are truly solving real-world problems while maintaining the flexibility to take advantage of new technologies as they emerge.

Design thinking has long been used in consumer and corporate technology, but the healthcare industry has been slow to embrace this philosophy. It is becoming increasingly important, however, as we move toward a value-based healthcare model, which involves a broader ecosystem of partners and providers to deliver more integrated care. The needs of patients, providers and states all need to be considered carefully to achieve these ambitious goals.  

Design Thinking in Five Steps

The process of design thinking generally involves five steps or stages. These include:

  1. Empathize. This stage provides an empathetic view into the situation from the perspective of the client or user, often through face-to-face interviews. The goal is to identify exactly who will be using the technology and what challenges they face.
  2. Define. Information gathered in step one is analyzed, refined and distilled into a simple statement or definition that communicates the problem. So, instead of saying, “We want to cut enrollment time by 25%,” we might say, “We want to make it as easy as possible for families to sign up for several social services at once.”
  3. Ideate. Brainstorming and white boarding fill up step three. Multiple ideas and potential solutions come from an array of multi-disciplinary teams, from software design to product development.
  4. Prototype. The next step is making prototypes of the best ideas. These are simple, working models. The goal is to create prototypes that can be further improved through ongoing feedback.
  5. Test. Finally, the prototype goes back to the users — often those who were interviewed in step one — for a trial run. Their responses determine the success of the solution.

These steps don’t always follow a completely linear path — depending on the situation, we can skip or repeat steps. Think of it as a framework that ensures we’re taking a user-centric approach to developing our software.

Design Thinking in Action

One example of successful design thinking is Gainwell’s Digital User Experience (DUX), which takes back-end technology and data and presents it to users in a way that’s intuitive, engaging and transparent. Before we began development, we sought input from end users and clients. When DUX reached the prototype stage, we met with end users as they interacted with the system. It gave us a better understanding of how people use our products, which led to a better experience for everyone.

From Software Vendor to Design Partner

Ask yourself, “what opportunities do you see for design thinking to create more efficient, effective and equitable healthcare in your system?”

As you select your Medicaid technology resource, it’s important to consider the philosophy of the company you’re choosing, and the clear advantages of becoming an integral part of the system design. You want a nimble, future-oriented company that will be a true partner.

About the Author

Jeff Reid, Senior Vice President and General Manager at Gainwell Technologies, is responsible for leading Gainwell’s Medicaid Solution Business. Jeff leads a team focused on using industry insights, government data and digital solutions to improve health for millions of Americans. Jeff works horizontally across the entire company and the external partner ecosystem to develop innovative products that will meet today’s and tomorrow’s challenges. Before joining Gainwell Technologies, Jeff was the leader for Humana’s Wellness business and created Humana’s Digital Center of Excellence where he served as the executive leader who led the digital transformation at Humana, including the web, mobile, and social platforms. Jeff was responsible for developing and executing Humana’s digital strategy by focusing on creating simple, data-connected and personalized digital experiences that empower members to achieve their best health. Prior to joining Humana, Jeff was Vice President of Digital Marketing, Strategy and Channels for TIAA-CREF Financial Services, where he led enterprise digital efforts and achieved the highest channel customer satisfaction in firm history. Jeff also previously served as an executive at The Hartford. He held several roles related to digital, including management of the flagship website, alongside mobile channels, and the employee intranet site iConnect. Prior to that, Jeff served 16 years at UPS, where he was responsible for managing UPS’s Global Digital Channel, including 104 country websites translated into 32 different languages. He defined UPS’s online channel strategy, execution and measurement. Jeff holds a Master’s Degree in Business Administration from the Moore School of Business at the University of South Carolina. His expertise stems from over 23 years of digital marketing and channel experience in several diverse industries including healthcare, financial, and business services. He loves being a husband, a father to two, and taking care of his West Highland White Terrier, Cooper.

Profile Photo of Jeff Reid