It was the right time and right place — from a healthcare standpoint — in Charlotte, North Carolina, at the Medicaid Enterprise Systems Community (MESC) 2022 national conference August 15-18. The event brought together colleagues and thought leaders from the state, federal and private sectors who share a common interest: enhancing the vital systems that support the Medicaid safety net.
Many themes emerged over 4 days of insightful dialogue concerning the state of the industry. These ranged from challenges states currently face, opportunities on the horizon and the promise of a more modern, equitable, human-centered future. Five key themes stood out to us, and we’re excited about the possibilities they hold for modernizing, streamlining, enhancing and expanding our approach to health and human services.
Theme 1: Medicaid transformation and modernization
We are moving away from monolithic applications and replacing them with agile platforms that can quickly scale up or down based on needs and conditions. Modular, configurable, cloud-hosted systems and solutions can deliver value more efficiently, which will be critical to states’ modernization journeys and can lead to business outcomes that contribute to healthier communities.
Theme 2: Human-centered design
We must design and develop solutions that are intuitive and user-friendly for all who interact with them — state agencies, providers, community-based organizations, beneficiaries and others. This calls for collaboration and design partnership; as we develop systems for the future, involving stakeholders and end users in the process ensures accessibility is inherent to the technology. Gainwell takes this approach with our clients, whose insight is helping us ensure our technology is meeting vital needs as the industry evolves.
Theme 3: Navigating the PHE unwinding unknown — together
Get ready. The unwinding of the COVID-19 public health emergency (PHE) is coming, although exactly when remains to be seen. In the meantime, there is a lot states can do to automate processes and ensure systems can scale up for the massive redetermination effort. There are several top priorities: ensuring members can continue to access the care they need; updating member contact information and keeping them informed; and pursuing process efficiencies that minimize the administrative burden on staff.
The good news is, we’re all going through this together — which presents a great opportunity for information sharing and collaboration to discuss best practices and lessons learned.
Theme 4: Process efficiency amid the Great Resignation
The imminent end of the PHE and impending wave of redeterminations comes as states are already grappling with an overburdened and understaffed workforce. How can they do more with fewer resources? Now is the time to pursue opportunities for automation — such as robotic process automation, machine learning and artificial intelligence techniques — to streamline processes, alleviate administrative burden and help prevent staff burnout.
Theme 5: Social determinants of health and health equity
There is more to healthcare than a member’s immediate illness or appointment with a physician. By using social determinants of health data and incorporating it into healthcare decision-making, states can identify and address social equity gaps. Technology solutions can help states achieve three key tenets of whole person care: integrating and coordinating multiple programs; addressing members’ immediate and long-term needs; supporting members in sustaining their wellness; and enabling secure, well-controlled information sharing.
Sharing a vision, paving the way
It was great to see so many of our clients and peers at this important and highly respected event. It reinforced our commitment to continue partnering with our clients to put in place many of the key principles discussed at MESC — from MES modernization to PHE unwinding to achieving health equity through a holistic health and human services approach.
We thank NESCO for providing this forum and all who put tremendous thought and effort into building a more efficient and equitable future for Medicaid. Gainwell looks forward to what MESC 2023 and the months ahead will bring to challenge and encourage us.