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Testing Modular Modernization of Medicaid MES Systems

Shift-Left Testing for Medicaid MES Modular Modernization

August 29, 2023


Modular modernization offers state Medicaid agencies many benefits to state Medicaid agencies seeking to upgrade outdated and cumbersome Medicaid Enterprise Systems (MES). With modular modernization, Medicaid enterprise systems are broken down into smaller, more manageable components which are upgraded individually. Traditional approaches to modular modernization involve multiple procurements and vendors followed a waterfall methodology, leaving integration and testing to the end of each project. This approach carries significant risks in that quality issues are generally only detected after significant effort has been expended and complexity added.

Shift-Left testing can be an invaluable technique for reducing project risk and increasing the quality of deliverables of modular modernization programs. Trigyn employs shift-left strategy to deliver wide ranging benefits in client Medicaid MES modernization projects.

Understanding Shift-Left Testing

Shift-Left testing, also known as early testing or shift-left testing, is a software development practice that emphasizes the early identification and resolution of defects in the development lifecycle (i.e. moving testing left along the project timeline). Traditionally, testing was often performed towards the later stages of development, which could lead to expensive bug fixes and time-consuming rework. Shift-left testing, on the other hand, involves bringing testing activities earlier in the development cycle, allowing issues to be caught and addressed before additional complexity is added making them more costly and time consuming to resolve.

The Benefits of Shift-Left Testing in Modular Modernization

Early Issue Detection: In modular modernization projects for Medicaid MES systems, Shift-left testing can play a crucial role in identifying issues within individual components as they are developed. Shift-left testing ensures that defects are caught early, minimizing the chances that a defect will impact follow-on stages of development, and reducing the overall cost of fixing defects.

Reduced Risk: By identifying and resolving issues early, shift-left testing reduces the risk associated with system failures, unexpected behavior during integration, project delays, and unforeseen costs. This is particularly important in Medicaid MES and MMIS upgrade projects which typically involve high degrees of complexity and multiple vendors. Shift-left testing provides additional benefits for healthcare systems where even minor bugs have the potential for significant implications for patient care and administrative processes.

Enhanced Collaboration: Shift-left testing promotes collaboration between development and testing teams. When testing activities are integrated into the early stages of development, it fosters better communication, alignment, and shared understanding of project goals and requirements among team members. Improved collaboration is especially valuable in multi-vendor environments which are typical in Medicaid MES upgrades.

Faster Feedback Loop: With shift-left testing, developers receive immediate feedback on their code's functionality and quality. Early and regular feedback allows developers to adjust their approach and helps ensure that the final product meets quality and performance standards, thereby accelerating the overall development process.

Improved Scalability: Modular modernization often aims to make systems more scalable and adaptable to changing needs. Shift-left testing aligns with this objective by proactively identifying performance bottlenecks, ensuring that each Medicaid MES module can scale horizontally and vertically, and maintain performance based on realistic load patterns, enabling seamless integration and deployment of the modernized components.

Cost Savings: Shift-left testing helps in catching defects at an early stage, which typically allows them to be resolved more easily, translating into reduced development costs. As the development process progresses, undetected bugs are typically layered with additional complexity and dependencies making them more time-consuming and costly to fix. By addressing problems early, shift-left testing can contribute toward significant cost savings.

Enhanced User Experience: A modular modernization project involves transitioning from an outdated system to a more user-friendly and efficient solution. Shift-left testing can help validate that each module contributes to an improved user experience, allowing for any needed adjustments to be made at an early stage, and ensuring that the end product aligns with the client’s usability expectations.


Modernizing Medicaid Enterprise Systems can be challenging however the benefits provide ample justification. Embracing modular modernization and incorporating shift-left testing into the development process can pave the way for smoother integration, enhanced quality, reduced risks, and on-time delivery. By identifying and resolving issues early, improving collaboration, and accelerating feedback loops, shift-left testing can be a pivotal practice in ensuring the success of these complex development projects.

Tags:  Medicaid