Best Practices for Managing Your Medicaid Enterprise System

In the evolving Medicaid Management landscape, the shift from a monolithic Medicaid Management Information System (MMIS) to a Modular Medicaid Enterprise System (MES) presents both challenges and opportunities. For state Medicaid agencies, mastering the integration and management of MES modules is crucial for delivering efficient and effective services.

We’re taking a look at new insights from Track 2 of this year’s Medicaid Enterprise Systems Conference (MESC). We looked at how to do things correctly, manage many different vendors and modules, monitor projects, move from Design, Development and Implementation (DDI) to operations and Organizational Change Management (OCM).

Invaluable insights into improved MES operations.

1. Embrace MES program governance: Effective governance is the cornerstone of a successful MES implementation. Establishing a robust governance framework ensures that all stakeholders, including MES module vendors, adhere to standard processes. This traffic cop approach provides clear direction and coordination between the system and human resources, essential for MES enhancements. Key success factors include:

• Including governance requirements in requests for proposals and contracts, tied to service level agreements.
• Securing sponsorship and support from state executive and senior leadership.
• Implementing effective Project Management Office (PMO) management and facilitation.

2. Integrated project management: An integrated project management approach is vital for managing the complexities of MES. In the MES PMO Projection Management Plan, Schedule Management is essential for handling both DDI and Maintenance and Operations (M&O) project priorities that happen at the same time within the Medicaid enterprise. A resource-loaded integrated project schedule helps identify dependencies within and across projects, allowing for effective tracking and mitigation of schedule issues. This approach improves communication, accountability, efficiency, compliance and predictable delivery across MES module vendors.

3. Transitioning from DDI to operations: Planning for a successful transition from DDI to operations begins at procurement. Clearly defined project requirements aligned with business goals and regulatory standards are crucial. For modules requiring certification, efficient progression through the operational readiness review and timely certification review are essential for delivering expected outcomes and maintaining service continuity.

OCM is a key component to successful implementation and transition to operations that's frequently overlooked . MES DDI projects can be stressful and time-consuming, especially for state resources that must perform their regular state job duties as well as provide support to MES DDI projects that have definitive timelines. It is key to engage state resources for OCM early in the DDI project and identify the key Change Champions throughout the state. Allow the Change Champions to be involved in illustrating how the state will move from their as-is processes to their to-be processes and champion these changes throughout the organization.

Furthermore, OCM should add a level of excitement and fun to the DDI project. Getting key personnel throughout the state excited about the project and the changes to come can make a stressful, long project fun. It can also make them feel like they are part of a team and have a personal stake in the project's success. Early engagement with OCM and excitement about the project is key to ensuring all stakeholders both internal and external clearly understand how their role in the Medicaid Enterprise is changing. This makes effective OCM important to a successful launch.

4. Lessons from Florida's MES integration: The state of Florida demonstrated the benefits of an integrated project schedule at the MESC. Their approach highlighted the importance of communication and accountability in achieving program and project management success across MES module vendors.

Ensuring Successful MES Integration

To effectively manage and operate a Modular MES, state Medicaid agencies should first focus on establishing a strong governance framework. This includes setting clear processes and standards for all stakeholders, ensuring robust project management practices and planning for seamless transitions from design and development to operational phases. Agencies should also prioritize communication and accountability among vendors to ensure successful integration and management of MES modules. It is important that each of these recommendations is managed through a central Program Management Office, where they are controlled by clear rules and processes. This will provide the program continuity as the state executes their Medicaid Modernization Roadmap to achieve desired goals. State Medicaid agencies can greatly benefit from NTT DATA's team's knowledge in managing and running their Modular Medicaid Enterprise Systems. With a strong track record in system modernization,

NTT DATA can help establish a clear vision and roadmap tailored to specific outcomes. Their experience in managing the complexities of multiple vendors, solutions and schedules ensures that your MES integration is handled efficiently and effectively. By working with NTT DATA, agencies can make their program goals a reality. They can handle the problems of integrating MES modules with expert help and get a successful project managed and done.

Embrace the future of Medicaid management with NTT DATA's expert team by your side. Learn more about our consulting services.