Analytics-based Medicare Solution for a US-based Federal Agency

Extracting meaning out of disparate datasets is challenging, more so when you’re a trillion-dollar organization struggling to leverage a tsunami of data, flowing from 50 Health Insurance Exchanges. So, when our client wanted a platform that could streamline integration and facilitate data analysis, we knew that we needed to create a disruptive solution that would be the paragon of new-age data intelligence.

Snapshots

Challenge:

Lack of real-time data exchange reduced efficiency and agile responsiveness; obsolete integration solution resulted in supply chain gaps and inconsistent service outputs; cumbersome administration and maintenance of the complex and vast IT integration landscape slowed down operations and delayed time to market for new solutions

Solutions:

Deployed a secure service gateway for real-time data transfer; modernized their integration solution using webMethods suite v9.12; upgraded the broker architecture to Universal Messaging for scalable, real-time messaging

Benefits:

Enabled real-time data intelligence; shortened time to market; improved decision-making and performance; increased agility and system availability and uptime

Key Challenges

Advancing the cause of Medicare-for-All, our client initiated a program that could support government-led health insurance coverage in the US. The program resulted in 50 health exchanges that helped companies offer healthcare coverage for their customers. As popularity grew, customer participation and workload increased dramatically, further exacerbating the data exchange and management. Clumsy communication led to ineffective decision-making and poor service.
Their integration solution was obsolete. With sub-optimal integration in place, various systems and applications were unable to perform at their full potential, straining agility, impacting process efficiencies, and affecting customer service.
The existing Broker Architecture, which allowed an active-passive setup only, was a major fault line. The integration landscape required long downtimes, which impacted system availability and slowed down time to market for IT solutions.

Our client is the main body of the United States federal statutory law, responsible for the intake of taxes and pursuing and resolving matters concerning erroneous or fraudulent tax filings. The company processes over 245 million tax returns in a year and has registered $3.4 trillion in revenue.

Our Solutions

Our Solution Engineering team objectively analyzed various aspects of the client’s business and architected the most advanced, real-time secure service gateway and Enterprise Service Bus (ESB) solution. This facilitated agile, standardized web services (SOAP 1.2), including the latest in Message Transmission Optimization Mechanisms (MTOM), for seamless data interoperability. We also designed an infrastructure with in-memory grids to ensure high availability and scalability of data across clusters of servers. In addition to this, we enabled secure gateways that connected network resources in a protected environment and ensured resilience.

We also upgraded the existing integration solution, spread over 300 servers across 11 environments, using Software AG’s webMethods suite v9.12. This helped ensure IT homogeneity and consistent process deliveries. We also developed mission-critical integration between Modern Electronic Filing (MEF) and an Automated Verification System (AVS), two of the most intensive, high-performance applications, over the Universal Messaging layer.

Our solution included the introduction of Universal Messaging, which enabled real-time data streaming across our client’s enterprise, web, and mobile landscapes. We also deployed the Active File Transfer MFT Solution for better monitoring and access control over file systems and transfers.

Finally, we provided a solution to automate the CI/CD process. This eased release planning and enabled proper auditing of all changes across environments along with automating the testing of deployed changes.