MJ july 1

After observing different vendors perform State Self-Assessments (SS-A) in multiple States, I had lots of thoughts about how to improve the process. During these projects, I listened to my State colleagues’ concerns about the amount of time, staff resources, and money an SS-A incurs. I started to notice in the States that I worked with on the SS-A, after the countless hours spent interviewing staff, compiling documentation, and reviewing documents, the end project seemed to add very little value to the State Medicaid program. The States did not know what to do with their SS-A results and most of the vendors did not offer much guidance and direction. As a result, the SS-A report became a “shelf project”; i.e. a document that sits on a shelf and is never used again. What an excellent usage of our tax dollars!

MJ July 2


I believe that somewhere along this MITA journey, States and vendors lost sight of why the MITA Framework was developed. MITA is supposed to be used by States to: identify the performance of their Medicaid Enterprise; identify who their stakeholders are and how they interact with them; to define the future goals of the Medicaid program; and to develop a strategic plan for achieving their future goals. Unfortunately, after the SS-A is conducted, States do not want to think about MITA for a long time. And so, they don’t. They don’t use the SS-A to identify opportunities for improvement. They don’t use the SS-A to identify gaps in their services. And they don’t use the SS-A to move the Medicaid Enterprise forward. It just sits on the shelf, collecting dust. The States that I have worked with, that was not their intent when they completed their SS-A. But other projects or initiative become a priority and putting their SS-A results into action quickly becomes an afterthought.