Medicaid Enterprise System Conference 2022: North Highland Insights

The Medicaid Enterprise Systems Community (MESC) is a national conference and community for state, federal, and private sector individuals to exchange ideas related to Medicaid systems and heath policy affected by those systems. In this newsroom article, North Highland experts leverage insights gathered at this year’s event to discuss key takeaways and trends you’ll want to know about. 

In August, North Highland had the pleasure of attending the 2022 MESC conference in Charlotte alongside some of the best and the brightest industry, state, and federal Medicaid leaders. The industry continues to evolve in response to the COVID-19 pandemic, modular MMIS implementations, streamlined certification, and delivering health equity. Below are some of the highlights, focusing on takeaways you can act on as you navigate these emerging and evolving trends: 

Prepare for the end of the COVID-19 Public Health Emergency by strengthening your muscle for change

The pandemic has challenged service delivery in ways that were previously unimaginable. It created high demand for Medicaid services and required state agencies to come up with flexible, quickly scalable solutions just to keep up. Innovative and interoperable solutions are taking center stage, helping states efficiently deliver critical customer coverage, expand access, and provide end-to-end care.

As the pandemic subsides, states are planning to resume normal operations with CMS providing guidance. Some states are considering keeping many of the actions taken during the PHE in place to maintain health equity, improve quality, expand access to care, and maintain continuity of coverage. North Highland can support your unwind plan development, mitigating risks related to staffing capacity and identifying near- and long-term improvements to your program processes and systems.

North Highland can help your organization leverage Agile technologies and methodologies to support your unwind plan development, mitigating risks related to staffing capacity and identifying near- and long-term improvements to your program processes and systems.

Align people, processes, and technology to adapt to an environment of continuous MES transformation

As states continue the transition from legacy, monolithic Medicaid Management Information Systems to a more modernized and modular MES approach, they are reimagining their business models and strategies for procuring solutions. States are talking with each other to learn the best way to manage multiple vendors, phase implementations, develop and execute to strategic roadmaps, partner with stakeholders to achieve program goals, focus on health outcomes, and address health determinants. North Highland understands that transformation is no longer a once-in-a-decade effort—it is a continuous journey.  North Highland can help you evaluate your operating model and organizational strategy and achieve delivery excellence in a multi-vendor environment, aligning the people, processes, governance structures, data, and technology involved in supporting your business.

Enable a focus on value through data analytics and testing

CMS continues to focus on results and value, as demonstrated by their implementation of Streamlined Modular Certification (SMC), and their consideration of proposed outcomes-focused updates to the MITA SS-A developed by the Public Sector Technology Group (PSTG). The SMC evaluates how well Medicaid information technology systems support desired business outcomes while reducing the burden on states. This streamlined, outcomes-based approach is designed to ensure that system enhancements and new modules demonstrate measurable improvements your program. North Highland can help you strengthen your testing and data and analytics capabilities so that your organization can demonstrate results and provide the metrics expected by CMS to receive certification.

Leverage data to advance health equity

CMS is working with states to advance health equity by designing, implementing, and operationalizing policies and programs that support health for all the people served by Medicaid programs, eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved, and providing the care and support that our enrollees need to thrive. Value-based payment program and service delivery are some of the changes necessary to address health care disparities.  Data-driven care creates more transparency and access to information, leading to better results, engagement, and experiences for Medicaid members, and it also supports the move toward data equity by helping you to identify where disparities exist and direct efforts and resources to address these disparities as they are identified. North Highland can help you close the equity divide and build a data-driven, nimble culture focused on mobility, productivity, and sentiment.