CommunityCare of Oklahoma: Modernization Improves Claims System Lifetime and Performance

What CCOK is Saying:

SourcEdge was quickly able to identify opportunities as the project progressed. It was clear that the SourcEdge resources had years of experience building and supporting Amisys-related applications and surround code. For CCOK, the migration to the cloud and the update of our core platform was our top IT project with incredible visibility. SourcEdge collaborated with our team to meet project timelines and budgets. Extensive testing and planning resulted in a successful go-live, with most customers completely unaware anything had changed. SourcEdge brought the experience and expertise necessary for success.

Rusty Wyrick, VP, CIO / CommunityCare of Oklahoma

Problem: Outdated Systems

In today’s changing landscape, health plans are continually challenged to modernize and extend the life of their systems.

When CommunityCare of Oklahoma (CCOK) approached us, their existing HP-UX servers were past end of life, and it was time to replace the current servers hosting their adjudication platform and enterprise databases.

With the existing platform, all computerized tasks had to be handled on site, and in the event of a disaster, CCOK estimated that its RTO (return to operations) would take a minimum of six months.

To make things more complex, the company had been using Amisys for more than 15 years, and over that time, it had been highly customized with surround code to fit their operations. The core system had not been updated in eight years and was three releases behind.

The capitalization cost of upgrading the servers in a ground-up build would have required a multimillion-dollar capital investment. The new CIO (Chief Information Officer), Rusty Wyrick, had another idea: build a modern, agile, cloud-based platform that would create greater flexibility and infinite scale while reducing capital expenditures. After achieving buy-in from the leadership team, they were fully aware that it would be a massive undertaking.

Solution: Upgrading Hardware, Updating Software, and Moving to the Cloud

Rusty reached out to SourcEdge, and we quickly recognized that the solution would have three distinct parts: upgrading hardware, updating software, and transitioning to the cloud.

This transition would involve work on servers, a number of updates on local workstations, modernizing operating systems, updating Oracle databases, and streamlining disaster recovery options.

SourcEdge: Discovering and Modernizing Code

To meet these objectives as effectively and efficiently as possible, we created a detailed project plan and worked as integrated members of the CCOK team. The project was a collaborative team effort, and our personnel brought unique skill sets that the company did not have internally.

Since the system had been highly customized, we worked with the business to understand thousands of lines of surround code. We then modernized the code to make it compatible with the new version of Amisys and the new Linux OS.

In going from HP-UX to Linux, we had to write new embedded code for the operating system. Because the primary source code of the application is patented by Amisys, the team wrote surround code to make the transition work. In addition, we updated the Oracle database to make it compatible.

Throughout the process, all downstream data was deidentified to protect member privacy and maintain compliance with state and federal regulations. We provided consulting, staff augmentation, additional developers, and EDI/configuration experts. We worked-hand-in hand with the client’s IT team and completed the project in just 14 months.

Results

1. Delivered the entire project within 14 months—on time and on budget—which allowed the teams to make their important KPI commitments.
2. Successfully upgraded Amisys to version 8.xx through a detailed step-by-step process. The team uncovered numerous bugs with the Amisys version and worked directly with the vendor to resolve all code issues and work through each version to successfully get to the final version.
3. Upgraded the obsolete HP-UX operating system to the current Linux operating system, which was required to run the current version of Amisys.
4. Upgraded Oracle from 12i to 19c utilizing SourcEdge’s Oracle DBA expertise.
5. Migrated the entire Amisys, Linux, and Oracle environments to the cloud in the Microsoft Azure cloud environment. The cloud migration happened simultaneous to the upgrade project.
6. Remediated 300 surround code applications by thorough testing of each application and providing SQL coding expertise to develop new code to ensure integration to the current Amisys version was successful.

Outcome Achieved: A Lightning Fast, Cost-Effective Solution

The client was taken from an old, antiquated system to a new, cloud-based system that is fast, efficient, and cost-effective. Employees are no longer tied to physical locations and can now work remotely, and the disaster recovery plan has been modernized to support an industry leading RPO/RTO.

We did away with excess and legacy applications that were no longer needed because the functions were included in the core product. The new system is also much easier to support, which in turn saves the client money.

Benefits

CCOK has seen a number of benefits from the upgrade, including:

• Increased performance of the entire claims processing environment.
• Significant savings on license fees.
• New, remote-friendly work environment, thanks to the cloud-based system.
• Avoided hiring additional personnel and the cost of one full-time position.
• Updated Disaster Recovery Plan; RTO has been significantly reduced.
• CapEx (capital expenses) have been converted to OpEx (operating expenses).
• Positioned for growth for the future; the new programs can now be converted from COBOL to C# and .NET on the Azure Platform.
• Increased focus on creating new products instead of spending time maintaining the adjudication system and an on-prem data center.