Medicaid Modularity: The Path To Better Outcomes
Amazon Web Services (AWS) led an initiative across the Medicaid Enterprise System (MES) vendor community to gather insights about progress toward modularity. Blue Tack is pleased to have collaborated with a top tier roster of vendors to produce a play book for Medicaid program improvement.
Trends and Directions in MES Customer Experience
Customer service in MES has been transactional for decades. However, there are trends that indicate the direction may be moving toward Customer Experience (CX). Have a look at Blue Tack’s take on CX in 2021.
Trends and Directions in MES Integration
Check out Blue Tack’s take on the MES Systems Integration market in 2020 and beyond.
Sidestepping Chaos
Lorrie Scardino facilitated a panel discussion with the Georgia Department of Community Health (DCH) and North Highland at the 2018 MES Conference in Portland, OR. Lorrie supported North Highland as DCH worked through its Medicaid Enterprise System Transformation (MEST) strategic plan to deliver its next generation modular MES. The presentation highlights some of the discussion, including DCH’s multi-phase strategic planning process, the activities and output of each phase and the decision frameworks used to perform key tasks. The presentation also addresses the methods used by the team to define roles and responsibilities, address governance challenges, develop implementation and operating models and evaluate existing state assets for reuse in the integration platform and future MMIS.
Using Integration to Advance Modularity and Drive Business Results
Lorrie Scardino joined David Whitham from the Massachusetts Executive Office of Health and Human Services to discuss integration as an accelerator for MES modernization. The presentation highlights the topics discussed at the 2017 MES Conference in Baltimore, MD, focusing on the System Integrator role and the Massachusetts integration journey.
Considerations for Sourcing the MMIS Systems Integration Role
At the 2016 MES Conference in St. Louis, MO, Blue Tack Consulting presented a framework for sourcing the newly created Systems Integration role for Medicaid replacement and enhancement projects. Lorrie Scardino, Blue Tack’s Managing Director, drew on best practices and lessons learned from other industry sectors to create an approach for states to define the Systems Integration role to meet the unique needs of each state while allowing the market to coalesce around a common set of requirements.
A Bold Solution for a Broken System: A Handbook for MMIS Reform
Lorrie Scardino, Blue Tack’s Managing Director, was selected by the Center for Digital Government and the Governing Institute to participate in the MMIS as a Service project. The work group consists of volunteers from ten state Medicaid Agencies and three private sector companies and was charged with studying alternatives to traditional MMIS replacements. In the first part of 2015, the group studied the benefits of a services approach and the obstacles to procuring, deploying and certifying MMIS as a Service under current and proposed federal funding rules. The group’s findings were presented at the Medicaid Enterprise Systems Conference in August 2015 and provided to Centers for Medicare & Medicaid Services (CMS) as it worked on the final rules published at the end of 2015.
Download the Report (you will be taken to the Governing Magazine website)
Managing the Risk of Innovation
States want innovation in the Health and Human Service Enterprise and many take steps to introduce innovative concepts and models. Because innovation challenges and changes the status quo, it is risky and governments, by design, are not risk takers. Therefore, the road to innovation is long and arduous. The health care industry has also been grappling with the innovation dilemma for decades. The good news is, the logjam is starting to break and case studies and best practices are emerging.
MITA-Size Your RFPs
Originally presented at the 2014 MES Conference in Denver, CO, Blue Tack’s founder, Lorrie Scardino, discussed the need to align RFP requirements with the MITA framework and provided practical ways to MITA-Size RFPs.
CMSÂ Resources
New MMIS 90/10 Funding
Effective as of January 1, 2016
This final rule extends enhanced funding for Medicaid eligibility systems as part of a state’s mechanized claims processing system and updates conditions and standards for such systems, including adding to and updating current MMIS standards. The new rules allow 90% federal match for modern computing and technology delivery models, such as open source, software-as-a-service and commercial, one-to-many applications, paving the way for MMIS modules to replace monolithic systems.
Private Sector Technology Group’s Comments Regarding Proposed Rule: CMS-2392-P
Medicaid Program: Mechanized Claims Processing and Information Retrieval Systems 90/10 Funding
Blue Tack Consulting participated with 15 other companies to present a unified response to CMS proposed rule changes for 90/10 funding for MMIS and Eligibility and Enrollment technology investments in the Spring of 2015. The comments helped shape the final rules, which were published in December 2015.