Client
State Medicaid agency
Industry
Government
Primary goal
Adopt a framework for secure AI adoption
Technologies
Generative AI
Make trust the foundation of AI transformation
Medicaid is a critical healthcare lifeline for residents across the US. To improve access, a State Medicaid agency set out to modernize its eligibility and enrollment system by exploring new artificial intelligence opportunities. The agency is accustomed to leading the way on technology, but that doesn’t mean racing ahead on AI without the proper guardrails.
From the outset, the priority was to ensure that potential risks of AI were understood, managed and governed with the appropriate guardrails in place to harness the technology’s rapidly evolving potential.
Client transformation journey
- Before
- During
- After
Building the foundation for responsible AI adoption
The agency is accustomed to leading the way on technology, but that doesn’t mean racing ahead on AI without the proper guardrails. The agency’s leadership identified the need for stronger security, privacy and governance guardrails to support responsible AI use.
To move forward with confidence, the agency needed a long-term strategy to enable trusted AI adoption at scale and supported by clear governance, accountability and controls to identify, assess and manage potential AI-related risks.
Establishing a strategic framework for AI governance
To address potential gaps in the agency’s AI security and risk management, a broader evaluation of the agency’s overall governance approach was undertaken. The KPMG in the US team conducted targeted assessments of the client’s existing policies and procedures.
Drawing on established National Institute of Standards and Technology (NIST) guidance, the team developed an initial AI security framework. Enhancements to the client’s existing acceptable use policies helped to align enterprise AI governance with the organization’s risk tolerance, while also establishing clearer oversight of documented AI use cases.
Enabling sustained, responsible AI governance
The agency strengthened existing policies and developed a future-state roadmap to support the ongoing identification, assessment and management of AI-related risks. The roadmap established the governance structures, controls and accountability needed to enable secure, responsible AI adoption.
With this foundation in place, the client now has a flexible and scalable approach to governance that integrates people, process and technology and enables innovation to move forward with greater confidence across the enterprise.
An experienced, multidisciplinary KPMG team continues to collaborate closely with stakeholders across the client’s organization to embed long-term governance into AI-supported processes. Built on principles of responsible AI, robust risk assessment and strong data provenance standards, these capabilities support ongoing oversight, accountability and well-governed AI use at scale.
How we make the difference
The Medicaid agency’s AI journey demonstrates that successful transformation requires more than implementing new technology. By helping the client turn the potential of AI into practical, responsible, enterprise-ready capabilities, the KPMG in the US team delivered strategic guidance, governance capabilities and advanced solutions to support trusted AI adoption over the long term.
If your organization is navigating complex challenges that could benefit from a tested, strategic approach to AI adoption, we invite you to explore how KPMG can help build a path toward responsible, trusted and scalable AI transformation.
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