Gainwell Technologies joined clients and stakeholders from across the health and human services ecosystem at the State Healthcare IT Connect Summit, held March 6-8 in Baltimore.
Each year, this key event unites states, federal agencies and industry partners with the shared objective of transforming and modernizing state health IT systems. Three years into a once-in-a-generation public health emergency and bound for a monumental process to unwind it, there has perhaps been no greater catalyst for Medicaid enterprise transformation than the key topics of conversation at this year’s event.
A Moment of Reflection on the Road to Redetermination
We now have an end date to the COVID-19 public health emergency (PHE) and a start date to recommence Medicaid redeterminations long put on hold by the continuous enrollment requirement. Workforce struggles and lack of reliable data are among the immediate challenges affecting states’ ability to get in touch with their recipients and transition them to other available coverage should they no longer be eligible.
Working through these challenges is offering the state healthtech community an unprecedented opportunity to reexamine how we approach eligibility and enrollment — what information we’re requiring from beneficiaries, what tools are available to meet them where they are and how we’re using technology with intent to drive better decisions and outcomes.
Today, we focus our efforts on meeting the Centers for Medicare and Medicaid Services’ (CMS’) ambitious definition of unwinding success, articulated by CMS keynote speaker Kia Banton: that nobody loses coverage. By working toward this goal, the hope is to minimize the number of coverage losses as much as possible.
Medicaid Enterprise Transformation: It’s About More Than IT
Technology is the enabler, not the driver, of successful Medicaid Enterprise System (MES) transformation and the benefits it delivers to providers and beneficiaries. That sentiment was echoed in various forums, from the Medicaid directors’ panel that kicked off day two of the conference to Gainwell’s own speaking session highlighting critical factors for MES implementation success.
Presenter Rajesh Sharma, vice president and general manager of Systems Integration, Interoperability and Analytics for Gainwell, offered an analogy to help put the case for MMIS modernization into perspective — using the recent collapse of a major airline’s technology system to highlight the potential cost and brand impact of an outdated IT infrastructure.
Along with co-presenters Shawn Knox, Trigyn Technologies’ technical director of MMIS Modernization / New Jersey Medicaid Modernization program executive, and Gainwell’s Fernando Mercado and Dinesh Laxman, the session offered a practical and actionable roadmap for a successful, risk-minimized Medicaid modularity journey. (Hint: it starts with documenting a clear understanding of program objectives and business needs; then comes the technology.)
Finding Connections, Moving Forward
If there was one — albeit unofficial — theme to emerge from this year’s State Healthcare IT Connect Summit, it’s that cross communication, collaboration and coordination are key to driving progress toward a healthier, equitable and sustainable future. From broadening the scope of healthcare to include the whole person’s needs to advancing interoperability initiatives and establishing the data-sharing mechanisms to support them, the actions we’re taking today are advancing us toward our collective goals as a community: better experiences, improved outcomes, healthier communities.