Legacy modernization in healthcare: modernize claims, benefits and enrollment without losing control

Healthcare organizations know their most critical platforms are often the hardest to change. Claims adjudication, benefits administration and enrollment workflows still run on COBOL, Synon and mainframe estates that have carried the business for decades. They also carry decades of embedded logic, undocumented exceptions and tightly coupled dependencies that few teams can fully explain. When those systems support thousands of screens, batch processes and cross-system workflows, modernization stops being a simple rewrite exercise. It becomes a business continuity challenge.

That is where Publicis Sapient and Sapient Slingshot help healthcare organizations move forward with greater speed and control.

Sapient Slingshot is an AI-powered modernization platform that helps teams extract buried business rules, generate reviewable specifications, design modern target-state architectures and produce maintainable Java and React applications with automated test generation built into the workflow. Just as important, it does this with humans in control at every critical step. Engineers, product owners and business stakeholders review, refine and validate outputs so modernization remains explainable, governed and aligned to real healthcare operations.

Why healthcare legacy modernization is uniquely difficult

In healthcare, legacy complexity is not just technical debt. It is operational logic accumulated over years of claims processing, eligibility determination, benefits configuration, enrollment workflows, billing interactions and service exceptions. Much of that logic lives in source code rather than documentation. Some of it lives in green screens no one wants to touch. Some of it lives in dependencies between systems that were never fully mapped. And some of it lives only in the heads of a shrinking pool of specialists.

That creates a familiar trap. The platform is too important to risk, too complex to rewrite manually and too slow to support the cloud-native, API-driven business the organization needs next. Claims accuracy cannot drift. Member service cannot stop. Enrollment and billing workflows cannot break. Yet staying on aging platforms keeps maintenance costs high, slows releases and makes it harder to improve digital experiences.

For healthcare leaders, the challenge is not whether to modernize. It is how to modernize without losing the undocumented logic that keeps the system working.

Start with business logic, not guesswork

Traditional modernization efforts often jump too quickly from old code to new code. That is where risk enters. If business rules are hidden across COBOL programs, Synon models, copybooks, screens and batch jobs, rewriting before understanding creates the possibility of claims defects, benefits errors and service disruption.

Sapient Slingshot takes a different approach. It begins by analyzing the legacy estate to extract business rules, dependencies, metadata and workflows from the code itself. That logic is transformed into clear, reviewable and testable specifications that become the source of truth for modernization.

This specification layer matters because it gives healthcare organizations something they often do not have: a shared, inspectable understanding of how the current system actually behaves. Teams can review claims logic, enrollment rules, workflow paths and dependencies before transformation begins. That reduces reliance on tribal knowledge and creates a stronger foundation for safe modernization.

From opaque mainframes to modern architectures

Once legacy intent is visible, Sapient Slingshot helps carry that context into the next stages of delivery. Validated specifications inform design artifacts, future-state architecture and modern code generation so teams are not starting over at every handoff. Instead of treating discovery, design, development and testing as disconnected phases, Slingshot connects them in one governed flow.

For healthcare platforms, that means core claims, benefits and enrollment capabilities can move from tightly coupled mainframe estates into maintainable, cloud-ready architectures built in Java and React. The goal is not modernization for its own sake. It is a platform that is easier to change, easier to support and better aligned to modern delivery needs.

This is especially important for organizations trying to shift from brittle legacy administration environments to cloud-native operating models. Modern architectures create a stronger foundation for ongoing delivery, service resilience and future product innovation. But they only create value if the business rules that matter most are preserved. That is why Slingshot keeps modernization anchored to validated behavior rather than assumptions.

Accelerate QA without sacrificing confidence

Testing is one of the biggest reasons healthcare modernization slows down. When a platform is poorly documented and deeply interconnected, QA teams are forced to reverse-engineer intent, recreate cases manually and check for regressions across a huge set of workflows. That is expensive, time-consuming and prone to error.

Sapient Slingshot helps reduce that burden by generating tests as part of the modernization flow. As rules and behaviors are extracted into specifications, the platform can also support automated test creation and broader quality automation. That helps teams improve coverage, speed up QA and reduce manual errors while validating that modernized applications preserve intended behavior.

In healthcare, this matters because quality is not just a delivery concern. It is a trust concern. Claims outcomes, member communications, coverage decisions and service workflows all depend on system behavior remaining correct. Automated test generation, paired with expert human review, helps teams move faster without treating quality as a leap of faith.

Humans stay in control

Healthcare modernization cannot rely on black-box automation. The stakes are too high. That is why Publicis Sapient uses Sapient Slingshot in a human-in-the-loop delivery model.

AI accelerates analysis, specification generation, design support, code transformation and testing. But humans remain accountable for business logic, exception handling, validation and release readiness. Engineers review generated artifacts. Product and business stakeholders confirm functionality. Teams maintain visibility into what changed, why it changed and how it maps back to the original system.

That operating model is critical in environments where continuity, auditability and control matter as much as speed. The objective is not lights-out automation. It is governed acceleration that reduces manual effort while preserving expert oversight.

Proven in healthcare modernization at scale

Publicis Sapient has already applied this approach to a leading healthcare benefits provider modernizing a large legacy administration estate. The environment included more than 10,000 COBOL and Synon mainframe screens supporting claims processing and customer service. Traditional methods had updated only a small portion of the landscape over several years.

Using Sapient Slingshot, Publicis Sapient helped uncover hidden business rules and dependencies, generate functional specifications, accelerate quality engineering through automated test generation and modernize into maintainable Java and React applications. The result was a migration completed 3x faster, with significant cost reduction and a clearer path to a cloud-native architecture.

That is the healthcare modernization story leaders want now: not just faster conversion, but faster modernization with business logic preserved, delivery risk reduced and service continuity protected.

What healthcare leaders gain

Modernize what matters most

Healthcare organizations do not need to choose between protecting today’s operations and building tomorrow’s platform. With the right modernization model, they can do both.

Publicis Sapient combines healthcare domain understanding, engineering rigor and AI-powered delivery to help organizations modernize mission-critical claims, benefits and enrollment systems with more confidence. Sapient Slingshot turns opaque legacy estates into explainable, testable and modern assets—so teams can preserve what matters, reduce risk and move toward a cloud-native future without losing control.