The 2018 Medicaid Systems Enterprise Conference (MESC) was held in Portland, Oregon this year and was my first time attending the event. For those unfamiliar, it is an annual conference that brings together thought leaders from the public and private sectors to share ideas and information related to Medicaid systems and initiatives.
There were thousands of attendees, hundreds of booths and vendors, and over sixty unique sessions and presentations. I attended many sessions and listened to leaders talk about Medicaid Information Technology Architecture (MITA), Certification, the opioid epidemic in the United States, Third Party Liability (TPL), and provider enrollment. In addition, I also observed vendors demonstrate different software and tools designed to help states. Throughout the various sessions, several common themes surfaced related to organizational change management, MITA and Certification, and Provider Enrollment.
States preparing to embark on modular certification should prioritize Organizational Change Management. When thinking about certifying a new system it’s natural for a state to think about establishing a plan to bring all the pieces together and develop the various deliverables required from CMS in the toolkit. These things are all important, of course, but it was interesting to hear about the necessity for a state to incorporate organizational change management into their strategy. This theme was highlighted by Minnesota, who is in the process of working to modernize all their legacy systems, while also managing day-to-day operations and mandated changes. The state recently completed a governance assessment and it is updating their governance structure based on the findings of the assessment.
MITA and Certification continues to evolve. MITA is a constantly evolving tool that states should utilize when thinking about modular modernization strategies. The Member Management Checklist is expected to be updated this summer. Another upcoming change that may occur is seeing the different checklist tracks eliminated. Instead of allowing individual states to decide if they should utilize the MMIS or the MITA checklists, CMS is considering only using the MMIS checklists. This eliminates at least one major decision point for states as they prepare for certification.
Provider Enrollment solutions are being identified and implemented. Provider enrollment has been a hot topic in Indiana in recent years and based on several sessions I attended, it’s a problem that is being addressed across other states. The good news is there has been significant progress with improving provider enrollment processes as states continually move away from paper processes into the digital world. The State of Tennessee, for example, has improved their provider registration period from 30 to 45 days, down to 2 to 10 days, with a 100% paperless system.
Lastly, the most important theme and message that permeated throughout all presentations and sessions is the overall sense of urgency and importance of serving the Medicaid population by thinking strategically and innovatively, eliminating waste, fraud and abuse, and continually driving towards systems and policies that help influence positive healthcare outcomes for vulnerable populations. This is a brief summation of my experience as a first time MESC attendee. I plan on attending the 2019 MESC in Chicago next year and I am looking forward to hearing about the outcomes and stories of the initiatives I learned about in Portland.