Transforming case management with a paradigm shift toward agility, accessibility

Case management is nothing new in government, but the unprecedented complexity of modern case management scenarios and the need for more flexibility in managing them are pushing the limits of legacy case management systems that many federal agencies still rely on today. Fortunately, the increasing availability of more dynamic and adaptable case management as a solution (CMaaS) platforms can help federal IT decision makers meet the challenges of modern case management. The key is to navigate the marketplace for the features and capabilities to put the most power and flexibility into the hands of case management teams.

Modern challenges to federal case management

From submitting a grant or funding proposal to managing social security benefits, resolving a tax issue, or any number of government administration activities, case management is the art of organizing and making decisions around particular processes in the federal government.

The problem is that the processes are getting more complex, and a fragmented and siloed technology ecosystem leaves case managers struggling through bottlenecks and delays that introduce error and degrade the experience for administrators and constituents alike. Especially in an established agency that’s built up operations over time, you may have numerous case management systems that don’t talk to each other and require users to learn multiple case management platforms to do their jobs.

Such platforms struggle to accommodate the flexibility needed for modern case management scenarios – where interactions are increasingly ad hoc, processes can be unstructured and you may need to access data from many different sources to evaluate cases and make decisions. To meet these requirements, case workers need flexibility in establishing workflows and autonomy in troubleshooting problems on the fly. But this is hard to provide when organizations rely on multiple, narrowly focused and uncoordinated case management platforms.

All these concerns are magnified in government, where case work is ubiquitous but often held back by legacy systems and paper-based processes. For example, many audit and compliance checks in the federal space are still done by hand, and workforce management, scheduling and task management systems typically lack AI capabilities. Throughout, case managers must contend with highly regulated processes and strict rules for provisioning technology resources.

A paradigm shift toward case management “as a service”

To solve the above challenges, a paradigm shift is needed – one that pivots away from separate systems devoted to individual processes, toward a more modular approach where case managers work with a core set of capabilities that they can customize for multiple case management scenarios. This case management as a service (CMaaS) model is a composable approach that replaces multiple legacy systems with a set of modular case management applications – all of which reference a core platform of powerful case management tooling and capabilities.

Critical to the success of this model is low-code design that – when combined with automation to streamline and scale processes easily – allows case managers to accelerate workflows and do their job in a much more efficient and flexible way. As an example, instead of requiring lines of code to be written to adjust a Medicaid reimbursement process, low-code could allow case managers to simply make the changes to a flow chart visualization and the platform would take care of writing the code to adjust routing information or other process steps needed to operationalize that change.

While there is no single approach to CMaaS and every implementation will need to be customized to an agency or division’s unique workflows and mission objectives, several key capabilities should be prioritized in crafting a successful CMaaS deployment. These include prescriptive capabilities to assist case managers in continuously analyzing and optimizing processes. With Medicaid, an advanced CMaaS platform could proactively identify inefficiencies and suggest specific fixes, such as repositioning when a certain reimbursement approval step happens in order to speed overall case resolution times.

The best solutions may also include process mining capabilities that allow case managers to observe how workflows are playing out in real time, as well as time-saving templates that speed development cycles by having low code already configured to address certain types of case management scenarios.  Throughout, automation is key for repeatability and scaling processes to the level required in a modern federal agency, and automation can take over many of the previously manual tasks associated with exception handling and issue resolution.

Transforming case management in government

While federal agencies face unprecedented challenges in modern case management, revitalized approaches like CMaaS are helping case management teams rise to these challenges. Instead of multiple, narrowly-focused point solutions for case management, the CMaaS model transforms the case management professional’s job with a core platform of robust capabilities they can customize to a wide variety of case management scenarios and processes. This new paradigm is redefining what’s possible when it comes to enhancing federal case management agility, speed and efficiency on behalf of agencies, their workforce and the constituents they serve.

Jason Adolf is industry vice president, Global Public Sector, Appian

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