Imagine Case Studies

Case Study: Steward Health Choice

Leo Pelletier, Systems Application Manager, Client Success Story | 2018

Introduction

Steward Health Choice (SHC) is Steward Health Care’s managed risk platform, which covers 534,000 lives in Arizona and Utah. Since Health Choice was established in 1990, it has significantly grown its core managed Medicaid plan membership, while building a robust provider network. Today, the diverse and growing Health Choice risk platform is comprised of health insurance plans, a management services organization (Managed Services), and accountable care networks.

Health Choice is at the core of Steward’s goal to integrate patient, provider, and payer components of the health care industry under one banner to deliver the best possible care in the communities where patients live.

"They have been nothing but gracious and available. MedMC really feels like our partner."

The Challenge: It's All in The Details

Leo Pelletier, Systems Application Manager, has worked with ImagineSoftware’s MedMC product for 15 years. MedMC is a start to finish automated software solution for managed care organizations. After ten years, he transitioned into information technology where he experienced more hands-on configuration with the software product and the MedMC support team. "I wasn’t working with the company when the MedMC product was implemented, but SHC has used MedMC since the mid 90’s," said Leo. One of the biggest challenges SHC faces on a daily basis is the level of detail needed to conduct business with the Arizona Health Care Cost Containment System (AHCCCS), or Arizona Medicaid.

Leo explained, "From a regulator standpoint, everything is configured at a fine level of detail. We require a lot of custom programming in order to administer the benefits of running this type of organization. From a technical point of view, onboarding new employees and helping them learn a brand new managed care system can always be difficult."

"I know the MedMC team well. They will do whatever it takes to get things done."

The Results: Customization, Support and Efficiency

Due to the nature of the business that SHC operates under, the organization needs a high level of customization, maintenance, and support from the product team. Leo elaborated, "We have a number of custom builds within the platform, so the MedMC support team has quite the challenge of implementing and maintaining the software for us. They have been nothing but gracious and available. MedMC really feels like our partner." Another major advantage of MedMC is transaction processing efficiency. "Since our version of MedMC is a mainframe-based system, the transaction speed is insane, even under heavy workloads. It can process an enormous amount of transactions in a small period of time," said Leo.

"Transaction speed is insane, even under heavy workloads. It can process an enormous amount of transactions in a small period of time."