The Challenge:

Since its inception over 50 years ago, Medicaid has come a long way. Medicaid now covers one in four Americans, at an annual cost of over $500 billion. The number of Medicaid enrollees is also on the rise, with a 4.6% increase from 2014 to 2015*. Even more alarming is the number of enrollees in the “New Adult Group**”, which increased 30% from 2014 to 2015. States are in a quandary trying to keep up with effectively processing the high volume of applications which will only continue to grow.

Our Solution:

eSystems Inc. is a global IT integrator with extensive experience in Medicaid, both MAGI and traditional Medicaid. Our technology solutions support integration across programs, including in the areas of consumer portals, eligibility systems and business rules engines, EHRs, call centers, electronic data matching, document imaging, data analytics, and mobile tools. Our system provides the ability to collect information once and disseminate it to the appropriate state entities, instead of each entity maintaining its own collection mechanism. This model creates reporting efficiencies for the state, and gives the state more timely access to data, streamlining the operations of many public health and beneficiary programs.

Why eSystems?

  • eSystems’ can provide a solution that facilitates Medicaid case management, along with integrated eligibility and benefits management
  • We have over 15 years of experience in successfully delivering projects for Medicaid eligibility and benefit management systems
  • Because we take an enterprise approach, we can advise on solutions that impact both medical assistance (Medicaid, CHIP) and social services programs
  • We evaluate the project from the viewpoint of the caseworker and the goals of the program, and then implement the appropriate solution


**New Adult Group is defined as “Childless Adults, including individuals that are not pregnant, are age 19- 64 (19 & 20 living alone), do not have Medicare, and could be certified as disabled but do not have Medicare yet (Source: