MicroPact Blog

Wisconsin DHS Deploys entellitrak to Support Medicaid Self-directed Benefits Program

Low-code COTS Solution Promotes Program Integrity and Data Sharing for Innovative $500M Waiver Program

August 9, 2018 | Healthcare and BenefitsCompany News

August 9, 2018, Herndon, VA | The Wisconsin Department of Health Services (WI DHS), Division of Medicaid Services recently went live on entellitrak®, MicroPact’s low-code application development platform for case management, to support its Medicaid Self-directed Long-Term Care (LTC) Benefits Program, known as IRIS (Include, Respect, I Self-Direct). The ~$500 million (annualized) Medicaid waiver program enables approximately 17,000 eligible adults to choose the long-term care services they receive in their homes and communities, resulting in better outcomes for participants and annual savings for the state of Wisconsin.

“Medicaid dollars consume a large share of state and federal budgets. With future funding levels uncertain, self-directed program models deserve consideration,” said Chris Sell, Wisconsin Self Directed IT System, System Administrator. “Not surprisingly, a common concern of lawmakers is that self-directed programs may be vulnerable to the perception of fraud and/or abuse. In Wisconsin, we have found the majority of participants take pride in managing their LTC service budget within the allocated amounts. With entellitrak, we have greater transparency, access to real-time data, and tighter controls with automated system validations that ensure program integrity.”

IRIS is one of the largest Medicaid Home and Community-Based Services 1915(c) waiver programs in the country, yet WI DHS operates the program with limited staff, reducing state administrative costs. More than 1,000 users from 14 different agencies access the web-based entellitrak solution to coordinate services and support LTC outcomes for IRIS participants, authorize and disburse payments to service providers, and manage and report on the program. They include social workers, nurses, and fiscal employer agents, as well as government analysts. Based on their role and system permissions, authorized users can access, report on, and share HIPAA-compliant information as needed.

“Just a few years ago, every contracted agency used its own siloed system. Now we all leverage one centralized case management system: entellitrak. DHS, DOJ, and OIG analysts all have direct access to program data, further mitigating the perception of fraud, waste, and abuse while providing evidence-based data to support decision makers,” said Sell.

At a time when many states are looking for sustainable models for delivering high-quality services to an aging population, they are also under pressure to replace their monolithic Medicaid Enterprise Systems with modular, interoperable solutions. The Centers for Medicare and Medicaid Services continues to offer guidance, but it’s up to each state to define its own modules and deployment strategy.

“MES modernization is a huge undertaking, and states are turning to each other to see what’s working,” said Kris Collo, CEO of MicroPact. “Wisconsin’s IRIS program stands out as the perfect microcosm — in terms of the innovative services it provides, the tax dollars it saves, and the COTS technology that can ensure solid program integrity with minimal staff support.”

WI DHS Division of Medicaid Services hosts entellitrak on Amazon Web Services (AWS). entellitrak is used by benefits and entitlement programs throughout the public sector to manage millions of cases annually, including eligibility, care management, and claims processing.

About entellitrak

entellitrak is a low-code application development platform for case management and business process management. Whether based on-premises or in the cloud, its Data-First™ approach allows it to be implemented immediately and configured continuously, enabling customers to get to work quickly while keeping costs low. 

About MicroPact

For nearly four decades, MicroPact has focused on engineering commercial off the shelf (COTS) solutions for the public sector. Today MicroPact solutions serve 98% of U.S. states, 97% of federal agencies with 500 or more employees, and enjoy a 97% annual renewal rate. MicroPact, the passion and technology that’s transforming government.

About Wisconsin Department of Health Services

The Department of Health Services (DHS) is one of the largest and most diverse state Departments in Wisconsin, with an annual budget of roughly $11.5 billion and more than 6,100 employees. DHS is committed to protecting and promoting the health and safety of the people of Wisconsin, making sure everyone can live their best life.

DHS oversees Medicaid, the single largest program in the state budget, and other health and social service programs. DHS ensures that the care provided to Wisconsin residents is high-quality and provided in accordance with state and federal law; ensures that Wisconsin taxpayer dollars are being used effectively and efficiently by preventing and detecting waste, fraud and abuse; and works to continue Wisconsin's long tradition of strong health outcomes and innovation. 

Tyler Technologies is the largest and most established provider of integrated software and technology services focused on the public sector

Related Solution

Home and Community Based Services

Secure, flexible, web-based software specifically designed to support both participants and administrators of Home and Community Based Services (HCBS) waiver programs.

Explore this solution

Powered By:

Health and Human Services Suite

Comprehensive solutions managing millions of claims annually – empowering agencies to better deliver services and benefits to deserving individuals.

Learn More

Powered By:

Health, Human Services, and Benefits

Comprehensive solutions managing millions of claims annually – empowering agencies to better deliver services and benefits to deserving individuals.

Learn More

Related Posts