It was great spending time with our clients at the annual MESC meeting in Denver this week. We enjoyed reconnecting with many state agencies and making new acquaintances as well.
Public Knowledge had great attendance at two of the breakout sessions with our Colorado and Wyoming clients.
MMIS Procurements in Today’s Marketplace
The first session titled ‘Procurements in Today’s Marketplace: Procurement and Evaluation Strategies for Creative Solutions That Encourage Competition’ was a highly interactive session around MMIS procurement, evaluation and protests. The State of Colorado Department of Health Care Policy and Financing’s Deputy Finance Office Director, Chris Underwood, covered several innovations in Colorado’s multiple RFP’s for MMIS, PBMS, and Business Analytics.
This session explored the significant risks for MMIS procurements and the lack of competition. Recent claims processing implementation and operational challenges have led states to explore more modern, innovative, adaptable, and modular solutions. However, states and vendors often rely on traditional RFP, proposal, and evaluation that do not consider modern service delivery models. We discussed how states could produce RFPs with clear requirements while looking for creative solutions that inspire vendors to invest proposal resources, appeal to non-traditional vendors, and encourage competition. We also discussed selecting the best vendor and solution to meet states’ needs as well as evaluation processes that are fair and impartial.
MMIS As Services
The second session titled ‘Challenge: Purchase MMIS Processing as Services Using Federal Match’ opened up a dialog around acquiring MMIS processing as services rather than systems using federal match. Wyoming’s State Medicaid Director, Teri Green opened the dialog with an announcement that Wyoming would be exploring a “services” approach to its upcoming MMIS replacement strategy. Caroline Brown of Covington and Burling covered the supporting language in CFR and other regulations for such an approach.
This session explored alternatives to procuring a traditional MMISs. Medicaid programs continue to grow in complexity while states face evolving regulatory changes. MMISs struggle to keep up with program and technical demands. Many implementations take 3+ years, while experiencing budget and schedule overruns. Consequently, many states are seeking alternatives. This session highlighted Medicaid claims processing and payment management as a service. This represents a paradigm shift in the way systems and services are acquired. We also discussed how federal requirements and contracting rules might apply to this type of framework as it relates to enhanced federal matching funds.
Looking to Continue the Dialogue?
Public Knowledge is currently scheduling meetings with State Medicaid Agencies throughout the country to expand on MMIS procurement and starting down the path of MMIS as services rather than systems.
Our first meetings are occurring in early September and continue through December of this year. If you are a state with an interest in MMIS planning and procurement, we want to meet with you. We will come to you for a brief 30 minute meet and greet or can allocate up to 4 hours to provide an in depth look at where the MMIS market is headed based on real experience drawn from our current projects.
If you are interested, contact Nicole (McNeal) or Jim (Plane) at MESC2014@pubknow.com to schedule a meeting. In return for your time we promise to deliver information of value to you, tailored to your situation. These are not sales calls. These are “let’s get acquainted” meetings to better position each of us for future Medicaid systems and services opportunities.