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Maybe states should break up Medicaid management systems

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Tod Newcombe, writing in Governing magazine’s Web site, notes that the  technology upon which most states run their Medicaid programs “is old, clunky and slow. To make matters worse, the expansion of Medicaid in a number of states under the Affordable Care Act has only put more pressure on these aging systems. Now nearly a quarter of states are looking to modernize them…. But officials aren’t eager to risk a lot of money on another system that will be old, clunky and slow by the time it’s completed.”

Mr. Newcombe  suggests that states looking for a better way to manage to manage their Medicaid programs might look at breaking up their Medicaid Management Information Systems “into pieces and turn some of those pieces into a service.”

He notes that in in April, “the Centers for Medicare and Medicaid Services proposed updating the polices that govern the certification process for building a MMIS, and thus making it easier to develop separate modules for, say, claims management or pharmacy benefits, instead of building the entire system at once. The federal agency is also revising its development requirements so that states will find it easier — and less risky — to adopt alternatives, such as contracting for a service.”



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