Our Services | Information Management

Developing New Database Systems for Community Health Advocates

Navigating the complex labyrinth of health care treatment and insurance is a challenge for tens of thousands of New York state residents. Since 1999, Community Health Advocates (CHA), a program of the Community Service Society, has played a critical role developing consumer-assistance programs that help health care consumers to obtain insurance, appeal denials of coverage, fight sky-high hospital bills, and address other coverage challenges. CHA’s menu of support services preceded the Affordable Care Act (ACA) but it is now, with ACA funding, helping consumers access new health insurance opportunities. CHA operates a toll-free helpline and counsels individual consumers in person at 30 locations around the state.

Metis has worked closely with CHA since 2006, when it built an automated case-management system for CHA’s New York City–based Managed Care Consumer Assistance Program (MCCAP). Metis created the user-friendly, flexible, web-based system that enabled MCCAP to meet the needs of the 1,300 low-income New Yorkers it reached each month and to fulfill the agency’s contractual reporting requirements.

Metis continued to play an important role as CHA was transformed into a statewide program based on the successful MCCAP model. In 2010, when CHA was launched to serve the entire state, Metis was asked to make modifications to the automated case-management system. Metis phased in the required changes so that the most critical new functions would be available to the new participating organizations throughout the state almost immediately, and other modifications were phased in as they were completed. The automated system helped CHA to complete 100,000 client cases in its first two years.

Metis also built a distinct computer system for CHA in support of its Small Business Assistance Program (SBAP), a group of 13 organizations around the state—mostly economic development corporations and chambers of commerce—created by the Community Service Society in 2012 to help small businesses prepare for the Affordable Care Act. The SBAP was the first program in the nation to train small-business-serving groups to help their constituents obtain health insurance coverage for their employees and apply for ACA-related tax credits. In its first year, SBAP provided 1,118 counseling sessions to small businesses.

Metis continues to monitor, maintain, and enhance both of these data systems and in 2013 developed an interim enrollment process for New York’s insurance exchange in anticipation of its start-up with the implementation of the ACA in 2014.