Results over Process

Projects are undertaken to accomplish specific goals and objectives. The goals can be broad like “be on time” or “complete the project within budget” or “meet user requirements”. Better yet they can be more specific such as “improve user productivity by 15%” or “Reduce claim processing errors by 24%”. Projects always have multiple goals and objectives that, if met, define the project as being “successful”.

We often lose sight of this and focus on the methods a project is following rather than if that method is moving the project toward meeting its goals. For example, we assess if the project is adhering to specific project management practices and standards independent of the efficacy of those practices. There are many viable ways for a project to meet goals and objectives. Ensuring certain processes and standards are followed is not a guarantee the project will succeed in meeting it’s goals and objectives. It’s easy to focus on processes and standards and lose sight of the larger picture.

The point here is simple. Each project needs to:

  • Understand its primary goals and objectives (and there are typically no more than a dozen),
  • Determine a way to objectively measure progress toward accomplishing those goals and objectives,
  • Regularly track and report on progress toward goals and objectives, and
  • Use this information to assess if the processes followed and standards applied on the project are effective.

By telling you if a project is making measurable progress toward it’s goals and objectives, through the use of empirical metrics, you have a real lens through which you can assess if a project as a whole is succeeding.

Public Knowledge specializes in developing meaningful metrics to help you succeed on projects. If you’d like to hear more drop us an email at

Successful Change Adoption

When an organization implements a change – whether it is an organizational restructure, a new way of business, or a new system – it’s important that business objectives are realized. It’s usually top-of-mind to recognize what is changing with technology, new workgroups and meetings that need to occur, and even changes to business processes. 

But it is also important to remember that your employees’ adoption of the change is necessary to call it “successful.” Outcomes related to work place changes are based on each employee understanding why the change is happening, what they need to do to get ready, and how it impacts them. Any change can suffer from slow adoption and low utilization. 

Organizational change management (OCM) consists of a variety of readiness activities designed to prepare people to adopt the change. It addresses the people side of change. OCM typically includes the following elements.

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Change initiatives succeed when the foundational elements of leadership, project management, and change management work together. But a “one-size-fits-all” approach is not effective for change management. Efforts can be right-sized to fit your organization and the impact of your change.

Whatever approach you take, the gist is the same: OCM will help individuals, teams, and organizations with the transition to a desired future state. It is about managing the “people side of change” and helping each impacted person make the transition successfully. 

If you have questions about how an OCM effort could help your change, drop us an email at

Alternatives to MMIS

Naomi Snodgrass of Public Knowledge has been leading a project with The Center for Digital Government (CDG) to look at alternatives to traditional MMIS replacement. Most recently, the work group–which consists of volunteers from several states and private sector companies–submitted suggested changes to the CMS certification criteria to allow states to get 90% match for MMIS functionality that is implemented using a services model. Naomi is quoted extensively in CDG’s new handbook for MMIS reform, “A Bold Solution for a Broken System” now available on Governing magazine’s website:

PK is leading the charge to lower costs, effort, and risks associated with replacing MMIS systems. Please contact us at for more information.

MESC in August – Hope to see you there!

We will be speaking at the Medicaid Enterprise Systems Conference in August on MMIS as a Service Model and Preparing for DDI. These presentations will be co-presented with industry partners including two of our clients. The conference will be held in Des Moines, Iowa on August 17-20th. Registration is now open and more information can be found at In our talks we will discuss:

A New Strategy to Acquire an MMIS as Services Not Systems – What would alternatives to procuring an MMIS look like? Last year the State of Wyoming announced at MESC that it had started the planning process to replace its MMIS. Due to its low volume of claims and other transactions, Wyoming also announced it would be investing in services rather than systems. What does that mean? What is their strategy? One year later, we can discuss the initial results of Wyoming’s planning and acquisition steps. This session highlights the practical aspects of planning and pursuing a services-based strategy, or creating a DDI-free zone for your program.

Preparing for DDI – As with any large, complex project, Medicaid system Design, Development, and Implementation (DDI) will involve multiple organizations, numerous internal and external resources and stakeholders, schedule coordination, complicated technical needs and, of course, change management. As such, multiple challenges are associated with DDI. The Colorado Department of Health Care Policy and Financing, Public Consulting Group, and Public Knowledge will collaborate as a coordinated panel to share their insight, experience, and encourage group discussion on how states can begin to plan and prepare for system DDI. Topics for discussion with the panel include:

  • Creating realistic and enforceable timelines.
  • Engaging in organizational readiness and change management efforts prior to entering the design phase of DDI.
  • Ensuring that testing remains an important consideration throughout the DDI effort.
  • Establishing project controls to address risks related to schedule, scope, and budget.

What is MESC? “The national Medicaid Enterprise Systems Conference (formerly the Medicaid Management Information Systems – MMIS – Conference) is an annual meeting for State, federal and private sector individuals to provide opportunities for the exchange of ideas related to Medicaid systems and heath policy affected by those systems.” PK attends this conference annually and we’d like to talk with you more about our presentation topics. Come find us at MESC or contact us at Hope to see you there.

MMIS as a Service: Don’t Leave Your People Behind

We know states are currently exploring options for Medicaid Management Information Systems (MMIS). Options for states include:

  • Keeping their current MMIS and fiscal agent provider,
  • Procuring a takeover vendor to operate the current MMIS,
  • Procuring a new MMIS in the traditional model,
  • Partnering with another state to use their MMIS or procure a system together,
  • Implementing multiple commercial, off-the shelf (COTS) solutions, or
  • Procuring in the new model – MMIS as a Service.

In exploring options and implementing these systems there are two “sides” to success: “Getting the system ready for the people” and “Getting the people ready for the system”. “Getting the system ready” is the technical work: requirements, procurement, design, coding, testing, etc. “Getting the people ready” involves some softer skills and work: policy, procedures, organizational structure, job descriptions, coaching, training, communications, etc. Too often projects focus on the former and forget or are too busy for the latter. They pay a price for this with unhappy people and a troubled implementation (and even failure!).

Organizational change management (OCM) addresses the “get the people ready for the system” side of a successful project. It is used to prepare end users and stakeholders for change. They need this preparation no matter which alternative you choose. In the new MMIS as a Service model in particular, your people will likely be working in unfamiliar territory. They will be feeling uncertain or unsettled about their role. They will not understand what the new model means to them, their clients, their organization, or their other stakeholders. They won’t know the policies, procedures, and structure they need to to be successful at work. They will need assistance to navigate change. Don’t leave your people behind. PK staff are experienced and credentialed in performing OCM for an MMIS and can make sure your project doesn’t leave your people behind.

Public Knowledge, LLC helps clients procure and implement MMIS systems. We are currently assisting multiple states in evaluating their options for an MMIS and planning for the impacts that will have on their “people”. We are leading the charge to redefine MMIS as a Service. For more detailed information, please contact us (

More HIPAA, Less MITA – 2

More than 10 years after the initial implementation of the HIPAA Transaction and Code Sets Rule, it’s time to celebrate. HIPAA required that a health insurance claim is in the same format and uses the same data everywhere. There are at least 8,000 carriers, third party administrators, and other health plans processing claims that look just like your Medicaid claims. CMS, in ushering in the first wholesale standardization of processing health care transactions, was brilliant.

MITA, on the other hand, has proven to limit competition within the MMIS industry. It has resulted in fewer MMIS vendors, not more. And more MITA consultants, with ever larger fees for state self-assessments.

We are attempting to turn that around by providing leadership to a work group that is looking at services based approach rather than systems for MMIS functionality.

Let us show you how to utilize services rather than systems to achieve efficiency and modernization in your Medicaid operations. Contact us at

More HIPAA, Less MITA – 1

As one of the leading consultants to State Medicaid agencies, why in the world would we suggest less MITA? The reason is simple. We believe MITA Assessments are too expensive and provide too little real value. You know it and we know it. Our clients and indeed the whole industry benefit from honest and open philosophical discussions about which investments truly provide value.

Under too many situations, MITA has shown itself to be primarily a consulting product, designed by consultants and benefiting consultants.

We have turned that around by working with two state clients to achieve the MITA goals through a reduced effort MITA state self-assessment that is fully compliant with federal requirements.

Let us show you how to do the same so you can get moving on achieving higher MITA maturity levels without the usual drain on your staff and budget. Contact us at