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The annual Medicaid Enterprise Systems Conference (MESC) kicked off with a boom. Set in beautiful Portland, Oregon, the event welcomed the who’s who of Medicaid. Nearly 100 sessions are packed into 4 days of fun- filled announcements and discussions about Medicaid and where the industry is headed.

Day 1 rang in with an overarching theme: “What’s your next big idea in Medicaid?” If you weren’t able to attend, check out our MESC recap of key takeaways:

The need for state reusability. With increased interest, States have turned their focus to the concept of ‘state reusability’ in order to provide technology and processes that are flexible, sustainable, and reduce costs. Stemming from an April 18, 2018 CMS letter to State Medicaid Directors, which offered guidance to supplement its “Mechanized Claims Processing and Information Retrieval Systems (90/10), the letter reaffirmed the requirement of reuse: “Over the long run, reuse is expected to lower implementation and operational costs compared to custom or one-off solutions.” To achieve this, a state may elect to incorporate reuse in its design of new capabilities.  

According to CMS, this could include: 

  • Hosting software in a cloud, and making it available for other states to use 
  • Developing open source, license-free MES modules that are sharable with other states 
  • Sharing specific customizations or configurations to a commercial off-the-shelf (COTS) software products with other states 
  • Further developing software or systems created for the Health Information Technology for Economic and Clinical Health (HITECH) to support other business processes in the Medicaid Enterprise or connected to the Medicaid Enterprise. 

Innovation is the key to change. As Jeremy Vandehey, Director of Health Policy and Analytics at Oregon Health Authority stated, “states are leaders in innovation.” Today’s opening keynote emphasized not only how state agencies and CMS can drive change that benefits the market, but also examined the need for states to stay abreast of regulatory changes and their potential impact to adapt quickly. Sarah Miller, Senior Director at Audacious Inquiry, emphasized this further, during the CMS Welcome, proclaiming “we are the people we’ve been looking for” and affirming we are among the who’s who in Medicaid and together will bring great change. Her session offered insight into her goals and priorities for 2018 and beyond.  

Significant changes are coming. Sarah Miller also provided an enlightening talk on the role of healthcare payers in State ecosystems. “Given the sheer size of Medicaid – the $565 billion program constitutes 17% of health expenditures nationally – significant changes that we are almost sure to see in 2018 will reverberate in states across the country,” [1] was just one of the quotes included in her keynote presentation to emphasize the magnitude of Medicaid on all stakeholders – including states, government agencies, providers, payers, and consumers.   

Thank you for everyone that stopped by Softheon Booth #71 last night for Demos and Donuts.  To learn more about how Softheon is supporting States with Softheon Verify contact 

Check back tomorrow for our recap of Day 2 at #MESC2018. 



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