A Fortune 50 health plan serving 25+ million members set out to build something ambitious: a Duals Operating Model that could unify branding, simplify benefits, and deliver a genuinely better experience for the more than 1 million Dual Members it serves across 25 states — members eligible for both Medicare and Medicaid. The stakes were high, with strict Federal and State compliance requirements to meet and RFP commitments to fulfill, all while keeping member experience front and centre. But behind the scenes, the transformation was moving slower than the mission demanded. Every change to enrolment, claims, appeals, or reporting had to be manually tested before it could go live, and that manual effort was becoming the bottleneck that was slowing execution and standing in the way of the client’s bigger ambition to scale AI-powered delivery across the enterprise. To match the pace of its Duals strategy, the client needed testing to move as fast as its members needed care.
Through a strong partnership with the client’s AI Council, Ascendion designed and launched the AAVA platform, delivering $15M in cost savings over four years through automation initiatives.
Ascendion transformed the Software Testing Life Cycle (STLC) by generating 8,000+ test scenarios and cases for the Duals program and automating test data generation for critical functions including Enrollment, Claims, Appeals & Grievances, Customer Services, and Reporting — all integrated with CI/CD pipelines for seamless, automated execution.
Results were integrated into the AAVA OneView Dashboard for real-time test execution insights, while a parallel effort delivered a Power BI report migration with 40% cost efficiency.
Tech Stack:
Achieved 30%+ effort savings across the Software Testing Lifecycle, spanning strategy, test case creation, data generation, execution, and reporting.
Shifted left execution by four weeks for the Annual Enrollment Plan rollout, accelerating readiness for a critical compliance milestone.
Enabled the business to increase Medicaid membership across states and expand Value-Based Contracts (VBC) through faster, higher-quality testing cycles.
Improved member and provider experience through a unified One ID Card, integrated materials, and streamlined call centre and Appeals & Grievances processes.
Delivered 40% cost efficiency by migrating 500 MicroStrategy reports to Power BI through the AAVA platform, extending impact well beyond the Duals program.
