The Medicaid Enterprises Systems Conference (MESC) kicked off with a series of sessions pushing attendees to think about how to improve health care, Medicaid, and associated technologies. Set in Chicago, Illinois, the 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 health policy affected by those systems.
In case you were not able to attend, here is a recap of the key topics discussed:
The Da Vinci Project
The Da Vinci project is a private-sector initiative working towards accelerating the adoption of HL7 FHIR as the standard to support and integrate value-based care data exchange. This effort will minimize one-off solutions between partners in order to help medical organizations and health plans better deliver on clinical quality, cost and care management outcomes. Robert Dieterle of Enablecare and Mary Kay McDaniel of Cognosante say the project is now pushing for a Medicaid agency to get involved as they believe the project will help alleviate pain points experienced by payers: “Most of our use cases are found between provider and payer. We have a lot of interest in filling in the gaps to a provider’s resources.”
Dieterle and McDaninel said using new technologies, such as FHIR, CDS hooks, and CQL, will integrate previously time-intensive tasks into the clinical workflow o achieve significant efficiencies. They say by joining the project, Medicaid agencies can substantially reduce provider burden by acquiring critical patient information, obtaining prior authorization in real-time for certain common services, and minimizing rework by “getting it right the first time.” This all most importantly improves patient care and experience.
John Doerr is an American investor capitalist. He was also appointed by President Obama as a member of the Economic Advisory Board. Julie Boughn, Director of the Data and Systems Group at the Centers for Medicare and Medicaid Services (CMS), spoke with Doerr for a fireside chat to hear his thoughts on the Medicaid Enterprises Systems. He acknowledged that Medicaid is hard since each state’s needs are different. He said beyond this challenge, however, the technology industry does not well equip the health industry. He also said the states should do better than the Medicaid Management Information System (MMIS). Doerr commented on the importance of proper leadership in order to fix each state’s Medicaid issues: “We need to give the right care to the right people who need it. To do this, we need effective leaders and clear goals. We must use goals in our staff meetings and conversations, and track everything with data. Join us on the objective key results movement!”
Human-centered design is a philosophy that empowers an individual or team to designing products, services, systems and experiences that address the core needs of those who experience a problem. Shane Hatchett, the Deputy Medicaid Director of Indiana Family and Social Services, explained how Indiana worked to include human-centered design to create solutions for its Medicaid members. By fully understanding the circumstances and behaviors of Medicaid members, one can develop solutions that are integrated into the daily lives of Medicaid consumers and optimized for compliance. These solutions lead to better decisions that enable self-sufficiency and increased enrollment. Hatchett said, “We started really small–as small as transportation. We wanted to make sure that people had the transportation they needed to get to doctor appointments.” He said he then hosted design-thinking sessions to figure out the expectations of beneficiaries and their propensity to act. The team thought about the individual and what they needed in every area of their life, ultimately realizing they needed key strategic partners to help. In order to find these key strategic partners, they started with the most common social determinants. Hatchett says all efforts in human-centered design ultimately assists in disparities by “putting power back in the hands of those disempowered.”
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