Enrollment in Medicaid and CHIP shifted from 78.8 million in December 2024 to 77,050,295 in September 2025, a reminder that public benefit systems live under constant load even before anyone changes a rule or adds a new program. Vidhan Shah, a product leader at Intuit, has learned that modernization is ultimately measured at the moment a resident, a caseworker, and an auditor all reach the same answer from the same screen. As a CODiE Awards judge, he is trained to separate polish from proof, and in benefits systems, proof is whether the workflow holds up under pressure.
“Eligibility starts at the kitchen table, not in the office,” Shah says. “If the first screen feels like a trap, people quit before the system can help them.” He learned that lesson early while helping design and implement Rhode Island’s Unified Health Infrastructure Project, a modernization program that replaced a 25 year old eligibility system with a unified digital portal and a single worker portal for DHS staff.
Here is an illustrative moment that captures why the first step matters. A resident has gathered pay stubs and a lease, the form requests one more document they do not recognize, and the only feedback is silence. That is where trust starts. UHIP treated that moment as a design and policy problem, not a user failure, because silence produces the same outcome as denial. People disengage, and the system never gets the chance to do its job.
In UHIP, Shah helped run user experience workshops and storyboarding sessions that forced the team to walk the full path, citizen and caseworker, before writing requirements. A single online application replaced multiple paper forms and in person visits, and real time eligibility assessments reduced waiting periods from weeks to days. The goal was not to make forms prettier. It was to make progress visible, so a person could tell whether the system was moving and a worker could tell what to do next.
Modernization gets harder when eligibility is not one decision, but a stack of decisions that touch Medicaid, SNAP, child care assistance, and Medicare premium payments in the same week. A backlog is not a technical metric. It is a lobby full of people waiting.
Even small policy shifts ripple through intake, verification, case assignment, and payment. A system that treats each program as separate forces staff to build mental maps of disconnected rules. That is where mistakes multiply. It is also where frustration accumulates, because workers can see the human cost of delay, but they cannot see a clear path through the workflow.
UHIP’s mandate was a unified portal that served over 300,000 citizens annually while giving DHS workers a consolidated view across programs, a single source of truth instead of a maze of siloed screens. Shah acted as a liaison between state stakeholders and engineering teams, translating policy into technical specifications and then pushing those specs back through usability testing with real users. “We stopped asking, ‘Did we ship the feature?’ and started asking, ‘Did a caseworker get their day back?’” he says.
One detail from that period still shapes his instincts: the team treated document intake and validation as a first class flow, not an attachment at the end. When the portal could surface missing items early, workers spent less time reopening cases, and citizens spent less time guessing what went wrong. It did not feel glamorous, but it reduced the quiet churn that drains a program.
Large government builds do not survive on good intentions. They survive on alignment. Alignment is the hard part.
In Rhode Island, UHIP secured $112.8 million in additional federal funding in October 2015 to expand functionality, using Affordable Care Act provisions that could cover up to 90% of digital infrastructure costs. Funding at that scale is not a bonus. It is a contract that requires evidence, repeatability, and operational discipline, and it raises the bar for how clearly a system must explain itself.
Shah’s role sat in the messy center: he facilitated workshops that mapped legacy processes, coordinated phased rollouts, and ensured accessibility and fraud prevention requirements were embedded into the system’s behavior rather than bolted on at the end. He also had to make the same argument in different languages. To policy teams, the question was eligibility intent. To federal partners, it was whether the system could prove it. To engineers, it was how to migrate workflows and data without breaking eligibility decisions during cutovers.
That habit shows up in his judging work as well. As an International Conference on Research Trends in Artificial Intelligence and Data Science (ICIRAIDS 2025) judge, he evaluates research and systems that claim rigor, and he tends to look for the same thing he needed in UHIP: clear definitions, testable outcomes, and an honest accounting of what breaks when volume spikes.
Eligibility systems are often judged by what they approve, but they should also be judged by what they prevent. In fiscal year 2024, Medicaid and CHIP recorded an improper payment rate of 5.09%, totaling $31.10 billion. Those figures are not an abstract audit score. They represent the downstream cost of decisions that cannot be supported with documentation when scrutiny arrives. Paperwork breaks budgets.
UHIP invested in validation mechanisms and post eligibility verification, along with connections to systems like the National New Hire Database, because the cheapest error is the one you never pay. Shah describes it as building friction in the right places. “A denial is painful,” he says, “but a silent mistake is worse because it looks like success until the audit arrives.” The system’s goal was to make decisions legible, so workers could defend them, citizens could understand them, and the state could explain its reasoning without rebuilding the case from scratch.
He also pushed for training and workflow design that treated caseworkers as operators, not clerks. A portal can be technically correct and still fail if it forces people into workarounds. The most expensive bugs are the ones that become habits. UHIP was projected to save over $90 million annually and $40.55 million in general revenue, and Shah saw that savings does not come from one big feature. It comes from many small decisions that prevent rework and reduce exception handling.
The pressure is not easing. Medicaid expenditure growth is projected to rebound to 7.4% in 2025, and Medicaid expenditures are projected to grow 6.2% on average from 2028 through 2033, which means eligibility platforms will keep absorbing policy shifts while budgets tighten and scrutiny rises. Systems will be asked to move faster at the same time they are asked to prove more.
Shah’s view is that the next wave of modernization will look less like a one time replacement and more like continuous proof. It will require portals that can show why an outcome happened, not just what happened, and worker tools that surface exceptions before they turn into appeals or payment errors. In Rhode Island, the program’s impact also extended beyond operations, contributing significantly to a reduction in the uninsured rate by more than half since 2013.
He is now at Intuit, but the lesson he carries forward is older than any platform: trust is the product. As a member of the International Scientific Society, he stays close to the research community, yet he measures success in human terms. “People do not judge these systems by how modern they look,” Shah says. “They judge them by whether the answer holds up tomorrow.”