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States make headway on MMIS modular overhaul requirement

Cambria Solutions will provide planning and oversight for “significant upgrades” to Louisiana and Mississippi’s Medicaid management information systems.

Cambria Solutions will provide planning and oversight for “significant upgrades” to Louisiana and Mississippi’s Medicaid management information systems.

The upgrades to those states’ Medicaid systems are expected to lower costs, enhance care coordination, improve efficiency and provide better health outcomes, according to executives at the Sacramento-Calif.-based company, a national information technology and management consulting firm.

Cambria will oversee the design and implementation of a replacement for Mississippi and Louisiana’s current MMIS systems and the transition to “modularity,” which it describes as the breaking up of traditional, large systems into smaller, self-contained modules that lower risk and support innovation, the company says. “Each state will use modularity to help accelerate the transition to managed care and innovative delivery models.”

The Centers for Medicare and Medicaid Services called for modularity in its January 2016 MMIS regulation.

According to Cambria President Suzanne Vitale, Cambria’s upgrades will meet federal requirements, while aiming to please beneficiaries. “The consumerization of IT means that patients, beneficiaries and other users expect their interaction with government healthcare systems to be friendly, engaging and accessible,” she says.

As states make their choices for IT partners, experience plays a role. Mitzi Hochheiser, the Medicaid deputy director and chief technology officer for the Louisiana Department of Health, called the selection of Cambria an “easy choice,” based on the company’s experience in Medicaid across six states. “The new wave of MMIS projects demand a partner with an innovative, different approach,” he adds.

Mississippi recently expanded the scope of its MMIS replacement project so that Cambria could assist with enterprise-wide implementation of transformational goals. As the enterprise project management office, Cambria will oversee operational efficiency, instill project management principles across the agency and align the dozens of projects to the agency’s vision, Cambria says.

Cambria’s announcement follows news issued last month that Kansas has achieved Stage 1 certification from CMS on its modular MMIS overhaul, implemented in partnership with DXC Technology.

“[F]ederal standards call for plug-and-play Medicaid systems that enable agencies to add or swap functional components as market needs change, without the expense and disruption of replacing the underlying infrastructure that powers Medicaid systems,” says DXC.

The modules now fully implemented in Kansas with the help of DXC include one for provider management and enrollment, and one for program integrity utilization review. In addition, an enterprise data warehouse, installed by DXC in collaboration with Cerner, will provide claims analysis, as well as clinical and financial information across the state’s 400,000-plus Medicaid beneficiaries, the company says.

“Stage 1 certification of the Kansas Modular Medicaid System is a major milestone for the state of Kansas,” says Lee Norman, MD, secretary of the state’s Department of Health and Environment. “The newly implemented modules will allow us to deliver more responsive service to our members and providers, including shorter calls for members to customer service, faster response times for providers and eventual cost reduction to the state through early intervention on payment accuracy.”

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