I recently attended the 2022 State HIT Connect Summit in Baltimore, MD, to hear from states, vendors, and the Centers for Medicare and Medicaid Services (CMS) about strategies for implementing Health IT systems. While each state is different, several shared challenges were evident at the conference.
Overall, the states and the CMS are focused on ensuring vulnerable populations have access to healthcare during the Medicaid redetermination process. The challenges and opportunities associated with improving interoperability and sharing data to support the redetermination processes were shared by many attendees who collaborated on strategies to modernize IT systems and processes.
Preventing the loss of Medicaid coverage during the redetermination process
A significant number of Medicaid eligibility redeterminations need to be completed over the next few months. As a result, states are focused on assuring that vulnerable populations will not lose health care coverage during the redetermination process. The CMS noted that the redetermination process allows states to make long-awaited improvements to their systems, processes and outreach to Medicaid members. A wealth of data can be leveraged, shared, and integrated to assist states in automating eligibility redeterminations. The redetermination process is also a good time for states to develop strategies for leveraging social media and mobile devices to alert and assist members in taking any actions needed to avoid loss of Medicaid coverage.
Many states and Health Information Exchanges (HIEs) discussed the sharing of critical data to inform the state’s public health response to the COVID-19 pandemic. Interoperability between state agency systems and HIEs provided data on the spread of COVID-19 and information about the immunization status of populations and communities. HIEs were able to further share immunization data with care providers at the point of care to make informed care decisions and help Medicaid Managed Care Organizations coordinate services for their Medicaid members. In some states, changes to legislation were required before data sharing could be implemented. While a few states could rapidly implement legislation (even if only temporarily) to allow interoperability, others could not. Increasing interoperability between state agencies, HIEs, and care providers enables better public health and improves the quality of care for Medicaid users, and some state legislation may need to be updated to allow and facilitate data sharing.
Increasing standardization during the procurement process
The CMS requested that the Medicaid Enterprise Systems (MES) Private Sector Technology Advisory Group (PSTG) form a committee to develop templates and tools that all states could use for uniformity when developing RFPs to procure IT solutions and services. An NTT DATA Director and the PSTG Board Chair, Lisa Alger, facilitated a session to collect input from vendors. The session broke participants into four groups to strategize about:
- Writing requirements that reflect their specific MES objectives
- Writing an outcomes-based RFP
- Scoring and Evaluation of RFPs
- Determining key personnel/staffing
The recommendations from this session included mechanisms for ensuring that services and solutions meet performance criteria, that procurements are fair and competitive, and that states structure their RFPs to facilitate evaluating vendors on an apples-to-apples basis. Many of the recommendations would provide states with more significant opportunities to procure high-quality services and innovative technology solutions while also helping states continue their good stewardship of taxpayer dollars. The PSTG will review and incorporate the recommendations in the templates/tools they provide to CMS.
Post Date: 5/19/2022