Founded in June 2011 to take advantage of expected expansions of Maryland's Medicaid managed care program and, later, opportunities surrounding the U.S. Affordable Care Act (ACA), Riverside Health needed an enterprise accounting system it could scale up, fast.
"We filed our application with the State of Maryland in January of 2012," explains Matt Yancisin, CFO of the Baltimore-based startup. "At the time we were using a spreadsheet-enabled accounting solution but needed enterprise systems by our scheduled readiness review in late January 2013."
Expecting to run lean, Riverside focused on adopting SaaS-based applications for all systems including financial accounting. "We wanted to minimize our upfront infrastructure investments," Yancisin says. "Plus, we anticipated growing into other states and offering additional products, which we envisioned doing while simultaneously maintaining a low headcount."
These goals led to evaluating four enterprise accounting application vendors. "In addition to providing robust enterprise capabilities, we also sought a partner with health insurance experience they could lend us," says Yancisin. "This included experience with consolidations and growth because we already knew we'd have additional opportunities on the near-term horizon."
By late fall of 2012 SunGard Financial Systems (a division of SunGard, Wayne, Pa.) rose to the top. "It was the only provider that could meet all our requirements and do it within our tight deadlines," Yancisin says.
With the readiness review just 60 days way, implementation SunGard's iWorks began on December 1. "That time frame included the holiday season," Yancisin points out. "Fortunately, SunGard dedicated a senior representative to work with our three-person internal team. She offered significant guidance from her experience with other deployments."
During December the joint Riverside-SunGard deployment team gathered requirements, organized data and set up a chart of accounts, all allowing for expected growth. "We were very impressed with how organized the process was from SunGard's perspective," says Yancisin.
The team also worked with two other partners that fed data to iWorks, HealthEdge (Burlington, Mass.) for claims adjudication and Emdeon (Nashville, Tenn.) for claims payments. "Because iWorks uses industry standard formats, only small tweaks were required to get the data feeds right," Yancisin says.
In early January a test database was loaded into a development sandbox. "The only deployment challenge we ran into was minor disagreements between file formats," reports Yancisin. "They were fairly easily resolved."
By the readiness review all systems were live and onsite training led by SunGard representatives was complete. "We passed the readiness test and were issued a state contract within about a week," recalls Yancisin. "In mid-February we were accepting our first members."
Over the summer the 40-employee insurer realized it would soon have sufficient reserves to invest. "We elected to use SunGard BPO [business process outsourcing] to handle the accounting and transactional duties related to investing," Yancisin says. "At the outset SunGard assisted by supplying a list of custodian options. But, our team ultimately selected the custodian, chose an investment advisor and assembled our investment policy."
For 2014 Riverside intends to concentrate on building out the reporting and analytical functions of iWorks. From there, it's all about growth.
"As we grow, we believe the cost of ownership will be less than if we'd engineered the infrastructure internally," says Yancisin, noting he is part of a financial team of three and Riverside's IT 'department' currently stands at a two FTEs.
"We're not technology experts," Yancisin continues, "our expertise is insurance. So we've picked solutions like iWorks that will not only help us stay on the cutting edge but also grow more efficiently than we could have with a complex internal IT infrastructure. It was the right decision for us."
Anne Rawland Gabriel is a technology writer and marketing communications consultant based in the Minneapolis/St. Paul metro area. Among other projects, she's a regular contributor to UBM Tech's Bank Systems & Technology, Insurance & Technology and Wall Street & Technology ... View Full Bio