Electronic Health Reporter

Guest post by Adnan Ahmed, president of the health IT solutions provider CNSI.

Each year, health IT experts and state health officials from across the country convene at the Medicaid Enterprise Systems Conference (MESC) to discuss the latest technology solutions for serving a diverse and growing Medicaid population.

This year’s event was held the week of August 18 in Denver, CO, bringing together state, federal and private sector individuals who provided the latest insights for the exchange of ideas related to Medicaid systems technology.

With seven million new Medicaid recipients this past year alone, state Medicaid systems face the challenge of onboarding a high volume of newly enrolled recipients, but also benefit from the opportunity to collect a wealth of data that IT systems can utilize to help government health and human services departments optimize managed health care and patient service.

While Medicaid has long been known simply as a system of payments, IT solutions increasingly present the transformative ability to develop and experiment with new value add-ons that will introduce cost-cutting efficiencies while also improving patient care.

With those overarching themes in mind, here are a few key takeaways from this year’s conference:

Data Analytics Offers New Opportunities                                            

In her keynote speech, Cindy Mann, director of the Centers for Medicare and Medicaid Services’ (CMS) Children’s Health Insurance Programs highlighted that while simplification, modernization and coordination guide health IT solutions, each and every project is increasingly reliant on accurate data.

That goes for almost, if not all, the health reform initiatives CMS is currently involved in. And with good reason – health IT tools that analyze large swaths of available data points can identify useful patterns and provide enterprise views of health systems, so that federal and state health officials can take a big-picture view of a healthcare landscape to track, predict and prepare for what is needed to address potential healthcare management issues.

Cutting-edge analytical tools are of real value in the health care world, even more so if they are made interoperable.

Interoperability Opens Doors 

The Office of the National Coordinator for Health IT (ONC) recently released an interoperability roadmap that in the next three years aims to “ensure providers and individuals can send, receive, find and use a basic set of essential health information.” As a result, state health officials and IT solutions providers alike took MESC as an opportunity to examine how their respective Medicaid Management Information Systems (MMIS) connect both clinical and administrative data in alignment with the ONC’s proposed goals and so that data analytics are more easily accessible across the board.

Patient healthcare continues to evolve in a rapid manner and across the spectrum of government and commercial health care. As a result, the differences between those programs continue to decrease which allows common systems to become more effective and of greater use going forward.

Business Value is Part of the Equation

It is increasingly clear that the MMIS of the future has to produce business value relative to improving patient experience, population health and overall effectiveness.

Shifting the focus of an MMIS from optimized performance (how to run operations in an optimized way) to optimized care (better quality of care at reduced cost) happens when analytics and interoperability come together to create a value driven, collaborative environment that also makes business sense.