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Helping make healthcare more affordable

Helping make healthcare more affordable

We deliver the results that matter.

Ian Gilmour

Associate Partner, Management Consulting, KPMG in Canada

KPMG in Canada


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The arrival of America's Affordable Care Act (ACA) required US states to respond with varying degrees of healthcare reform. With a new approach to health coverage came the requirement for modernized systems, fresh perspectives, and the establishment of state-based health insurance marketplaces. It was a historic move in American healthcare coverage and a monumental challenge for state leaders.

To that end, many states engaged KPMG in the US to assist with identifying ACA requirements, assessing digital solutions, modernizing Medicaid systems, and working with health insurance stakeholders to set up markets in their respective jurisdictions – all in advance of ACA's October 1, 2013 deadline for open enrollment.

KPMG in the US called upon KPMG in Canada's decades of experience in developing public sector reference architectures for large scale transformations. To accelerate our engagements, KPMG in Canada assisted our KPMG in the US to develop an ACA toolkit to help states secure Federal funding, procure digital solutions and oversee implementation of their marketplaces. The resulting KPMG Enterprise Reference Architecture (KERA) toolkit for Health and Human Services has been deployed across Canada and the US over the past six years.

From Hawaii to Tennessee to New York State, KPMG teams met with leaders and representatives in 12 states to help them plan, budget, design, and eventually implement the healthcare operating models and digital solutions required to make ACA a reality.

Thanks to the commitment from our collaborators, and counsel from both internal and external public policy experts, our work set the standard for America's ACA healthcare transformation. Partner states such as Rhode Island and Connecticut were ranked among the best for their implementation of ACA solutions; our toolkit, embedded with the ACA's policies and business rules, helped get several marketplaces up and running in record time. This, however, was just the beginning of the story as we have continued to help states implement broader Medicaid reform and transform the delivery of human services to better serve communities in need.

From small-scale investments to $200 million overhauls, KPMG spurred ACA initiatives across the US in its work to help states bring a revolutionary healthcare vision to life. We helped to lay the path for a better, more united system of care, and left a roadmap for healthcare reform to be used by administrations to come.

We deliver the results that matter.

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