Business Case
CMA was awarded a contract with the HRA, to respond to two business needs. The Federal Personal Responsibility and Work Opportunity Act (PROWRA) and the New York State Welfare Reform Act gave HRA the flexibility to design programs to enable individuals and families to achieve self-sufficiency through economic independence. Also, the mayoral initiatives in NYC at the time expanded demands for program integrity, by assuring that everyone who receives public assistance and Medicaid is entitled to the benefits and amounts received.
As the project progressed, new opportunities for use of the system, and new priorities, emerged.
The Solution
To meet these dual demands, HRA and CMA began the development of an Enterprise Data Warehouse (EDW), with extensive reporting and analytical capabilities. The data warehouse went into Production with extracts from three core systems (WMS, NYCWAY, and Medicaid Fee-for-Service Adjudicated Claims/MMIS). Source systems, including SSA/the State Data Exchange, were added, existing sources expanded, and data geo-coded to ensure users’ needs and requirements were continuously met.
The EDW gave HRA’s business users extensive ad hoc reporting, querying and analysis capabilities. It also enabled the creation of automated interfaces to transactional systems that were not possible with the operational systems themselves. The EDW was built for extensive analysis of caseload dynamics and containment of costs, for mandated reporting, increased revenues, placement of liens, and detection of fraud and abuse.
As time went on, the EDW’s integrated data was used to address population expenditures, analyze data geographically, map data, and further facilitate user reporting, analysis, security, and fraud detection needs.
The Results
The EDW serves many business users, including the Office of Health and Human Services, the Office of Revenue and Investigation (ORI), the Office of Revenue Development and Automation (ORDA), the Office of Program Reporting, Analysis and Accountability (OPRAA), the Family Independence Agency (FIA), and more.
We support their business users, accessing large amounts of historical data from multiple systems to contain costs, place liens, detect fraud and abuse, increase productivity, and plan and evaluate programs. Currently, the EDW has more than 17 years of data (around 18 terabytes) and is made available to all users. This has positioned the EDW as the foundation for data sharing across HHS agencies, to allow a more holistic view of the client and services being received.
The Agency’s response to Hurricane Sandy showcased the EDW’s ability to provide quick, flexible access to data. Agency analysts used the EDW to quickly identify and provide disaster SNAP benefits to clients residing in areas hit worst by the storm. During the first six months, there was a 225 percent increase in Prescription Drug Fraud Detection, driving $12 Million in Fraud Prevention.
Overall, HRA has determined that data made available in the initial phases of the project helped yield $200 million in revenue. Moreover, data that once took more than six weeks to access is now available within seconds. The HRA Enterprise Data Warehouse is considered a New York City government “Best Practice” and is self-funded annually through the savings generated through its use. CMA’s solution for NYC HRA is estimated to have positively impacted revenue for the agency by over $1 billion to date.
Going forward, the EDW will be the cornerstone of the City’s plans to develop predictive analytics.