Author Archives: HITC Editor

Contributed by Matthew Moreau 
Matthew Moreau is the VP Solution Strategy, Government Healthcare Solutions, Conduent

As technology has advanced, Medicaid platforms have become increasingly complex. To help States successfully and efficiently modernize their platforms, CMS has guided them to break their procurements into smaller pieces so multiple vendors can work on facets of the project in which they have the most expertise.

As a result, system integrators are tasked with working in conjunction with each modularity vendor, connecting disparate technology and ultimately keeping the project on track.

My colleagues and I recently had the opportunity to discuss the role system integrators play in supporting platform modernization projects during a standing-room only roundtable session at the 2017 State Healthcare IT Connect Summit. Three themes rose to the top of our conversation:

1. Change management.
All parties are still adjusting to multiple vendors being involved in a Medicaid modernization project. The system integrator often enters an agreement while there is still much uncertainty with active procurements for the platform modules. For instance, the system integrator may not be aware of what the specific technology solutions module vendors will use, or even the vendors that will be involved in the project.

2. Accountability vs. authority.
The overall goal for the system integrator is to create an environment in which different vendors can work collaboratively, and ultimately ensure a project is completed on time. But at the same time, the system integrator might not always have the authority to take action when needed to meet those goals. An important question for State Medicaid programs to consider and system integrators to understand is, “when there’s a bump in the road and something goes sideways – what authority does the system integrator have to make or impact change?”

3. Contracting terms.
Contracts need to align with accountability and authority, and need to be as clear as possible in the role of the system integrator. It’s important for States to make their contracts appealing for bidders while still protecting themselves and ensuring a cost-effective implementation. Vague contract terms create risks for both parties (State and vendor) and often forces vendors to add assumptions and contingencies to their bid during the procurement process.

Conduent has extensive experience in Medicaid management, providing administrative and care management solutions to Medicaid programs and federally funded U.S. government healthcare programs in 26 states, Puerto Rico and the District of Columbia. Conduent has also received CMS certification for its Pharmacy Benefit Management module, the Conduent Flexible Rx System. We expect the role of the system integrator to become more standardized as more States begin their modernization projects. We look forward to observing how the system integrator role continues to evolve and continuing this conversation at next year’s State Healthcare IT Connect Summit!

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Everyone is talking about it. Customer Experience.
Tish Falco, contributor.  
Tish Falco is a Senior Director, Customer Experience, at General Dynamics Health Solutions.

It’s the latest buzzword that companies and organizations are chasing – but, truthfully, it is so much more. What does Customer Experience (CX) really mean? In its most simple form, CX is how a customer perceives their interactions with an organization. Beyond customer service and customer satisfaction, CX is how a customer views all interactions across all channels over time – not just during a single engagement with one person or channel (i.e. talking to a customer service agent to understand a recent bank transaction). CX looks at the entire customer journey to identify how interactions are related and where there are dependencies –considering the collective, various interactions across the customer’s relationship with the organization to truly understand the customer’s needs, wants and expectations. Below are five key steps for implementing a successful CX program.  

1. Develop a Clear Strategy and Vision
Based on citizen guidance, determine what future experience you want to deliver and ensure it is in-line with what customers want and employees can deliver.

2. Embrace Customer Insights
Through various forms of data, understand your customers’ needs, wants and expectations.
Leveraging tools like surveys, focus groups, voice and text analytics, and social sentiment can define the voice of your customer, driving strong CX improvements.
It’s not enough to collect this information, you also need to gauge how well you’re doing – CX plans should be actionable and measurable to allow for adjustments based on how well an agency is doing.

3. Align Technology and Processes
To avoid disjointed CX, use insights to make agile changes to both technology and processes for continuous improvement. As both are intertwined, it’s important to understand the dependencies and shape changes when making CX improvements.

4. Operationalize CX at the Right Level

  • To truly be successful, CX must be a strategic initiative, not a flavor of the month directive.
  • Create an organizational structure that is empowered and has sufficient, dedicated resources to help shepherd CX throughout the agency.

5. Transform Culture for Organizational Change

  • One of the most important ingredients in making CX sustainable for the long haul is focusing the same energy on employees as the customer.
  • Make CX part of your DNA by looking at how you engage your employees in their efforts to embrace CX – hire for and develop skills as well as provide rewards, training and the necessary tools for your people to be successful.

With the balance of power shifting from organizations to customers – due to citizens becoming more demanding, having better access to information and the ability to spread perceptions via social media – agencies must continue making strides to embrace CX and close the divide. Citizens come to expect fast and easy service using multiple devices with access anywhere, anytime. Based on private sector experiences, there is a need for agencies to start bringing the citizen’s voice to the decision-making table. The consequences, in addition to customers finding workarounds, is the potential for unwanted media attention and scrutiny that will negatively influence budgets, and ultimately, agency missions.

Contact General Dynamics Health Solutions at to learn how we can help develop a cloud solution that meets your technical requirements, business functionality and budget. To learn more about our cloud solutions, visit   

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Joseph Fiorentino, Managing Director H&HS, Accenture
sat down with HITC’s Rob Waters to understand more about the challenges states are facing in realizing the potential of their data analytics programs and to discuss the creative approaches being employed by states to engage with the vendor community to support actionable and timely insights to better serve their service re-design efforts.

Rob Waters: H&HS agencies hold huge potential in terms of the varied data stores they manage to measure performance and improve outcomes – what are some of the challenges states are facing in realizing this potential?

Joseph Fiorentino: Agencies are trying to move beyond compliance and operational approaches to creatively use data to reinvent service delivery and build a stronger network of care, however, many are struggling to glean value from data. A few factors are holding back progress. These include:

• Data privacy and security issues – This is the biggest barrier. Sharing data across an ecosystem is not without challenges for most agencies. Even those with good intentions often face legislative, process, cultural and confidentiality obstacles. Adaptive leadership approaches and creative strategies will help agencies to overcome this barrier.
• Demand for new skills – Analytics professionals today need new and more complete skillsets—a combination of business, data science, visual aptitude and technology, among other skills. These skills are in tremendous demand in the marketplace, and agencies must retain this type of talent to maximize their data.
• Architectures – Big data architecture must work hand-in-hand with traditional architecture to satisfy more complex analytics needs. Hybrid is the new reality to increase value.

RW: In a world of finite resources and often burdensome data-usage regulations, how are states evolving their approach to analytics to yield actionable insights in a timely manner?

JF: Agencies need a new data mindset if they are going to use data to improve decision-making, align finite resources, measure performance and improve outcomes.

Agencies that want to develop their own targeted analytics programs and get results quickly need different tools than most might expect. Many decision makers think that they must start with infrastructure. They assume the first step is to invest in data warehouses, data stores and the hardware and software necessary to support them. This is an expensive, unnecessary heavy lift—a three- to five-year project that often times does not yield desired results for data analytics.
Agencies have exciting opportunities to get straight to using data insights to benefit citizens. Rather than focus on infrastructure, agencies should focus on extracting value from the data they have, using fast, innovative methods. The key is to identify a specific problem or question to address and “work backward” to determine the data insight needed to solve it.

With this narrow focus, agencies can apply methods, such as rapid prototyping or rapid cycle evaluation, to reduce delivery time and improve services faster. These methods take weeks, not years, speeding insight to action. They are also highly adaptive, giving agencies newfound freedom to take risks and experiment with analytics. Agencies finally have room to “fail fast and fail small,” making near real-time course corrections to program approaches to manage risk while supporting a continuous focus on outcomes.

RW: Increasingly states are referencing the role of ‘partnership in analytics’, how have you seen the relationship between vendor, agency staff and policy makers evolve over time?

JF: To a certain extent, reform programs are driving progress as agencies are looking for creative strategies to share data and adopt analytics. Agencies recognize that traditional procurement processes and difficulty sharing data across an ecosystem are a challenge. Legislative, process, cultural and confidentiality barriers hinder even the best intentions.

Rather than struggling through a typically lengthy RFP process, agencies are having firms prequalify by participating in a “bake off” of their solution. This approach has benefits because it drives an infusion of innovation as firms big and small respond to projects. However, there will need to be a great deal of coordination and governance as agencies try to manage multiple vendors working off the same data using different techniques and technologies.

RW: For states who are currently re-assessing their H&HS analytics strategies, what advice do you have in terms of engaging the vendor marketplace and structuring procurements for optimal outcomes?

JF: An analytics RFP should encourage creativity and innovation. Engage with the marketplace prior to the RFP by fostering conversations and work sessions between the agency and the vendor.

Agencies should be transparent, if they have a strategy in mind, share it, and have the vendor community comment on it. Try to avoid product specifics, where possible, to keep the door open to new ideas and new approaches when communicating with the vendor community. One approach that is gaining traction is to prequalify vendors rather than go through a lengthy RFP process and select one vendor. After prequalifying vendors, work collaboratively with those vendors and have them compete on smaller projects. This gives agencies newfound freedom to take risks and experiment with analytics. In this model, agencies have room to quickly make course corrections on the relationship with the vendor.

Accenture is the Track 2 Sponsor: State Innovation, Data Analytics and Population Health Management *Accenture’s Joseph Fiorentino will also be co-presenting the track session as detailed below on Day 2 of the conference.
March 29th, 11.30 a.m.12.30 p.m EDT
Track 2
Analytics Make My Head Hurt! A Prescription for Actionable Insights

Joseph Fiorentino, Managing Director, Health and Human Services, Accenture
Martin Baker, MSc, Senior Director, Strategic Growth and Business Development, UMass Medical School

Register to Attend the 2017 State Healthcare IT Connect Summit | March 28th – 29th | Hilton Baltimore, Baltimore MD.

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Rob Waters, VP and Program Director with Healthcare IT Connect sat down with Mark Settle, Okta, CIO to learn more about Okta’s recent selection by CMS to support it’s identity architecture and to discuss the broader implications of cloud based ID management solutions for H&HS transformation!

Rob Waters: I’d like to initially congratulate Okta on your selection by CMS to help streamline and modernize it’s identity architecture, could you elaborate on the work Okta will be undertaking there?

Mark Settle: Thank you! CMS selected Okta to provide the Okta Identity Cloud as a key enabling technology for CMS’ Quality Payment Program (QPP). Over one million health care providers across the U.S. seek CMS reimbursement for their services via QPP. Okta provides cloud-based solutions for identity and access management. We were specifically selected for our agility (ability to scale rapidly and provide coverage for all CMS caregivers), user experience (simplifying the use of multiple user names and passwords) and security (end-to-end encryption and early detection of anomalous login behaviors). The Okta Identity Cloud is also extendable to other applications and services CMS may want to pursue in the future.

RW: Where does this fit into CMS’ overall modernization efforts and how will the solution ultimately impact CMS’ ability to better serve its’ constituents?

MS: Agility, user experience and security are foundational elements of the overall digital transformation that is occurring at CMS. Balancing ease of use with security is a tough task for any enterprise, but doubly so for a federal agency handling reimbursement for medical services provided to individual citizens. The Okta Identity Cloud provides single sign-on, directory management, user provisioning and multi-factor authentication, which can be deployed and adapted to achieve the appropriate balance for CMS’ mission, not only in the context of the QPP program but for other programs as well. Okta’s comprehensive solutions for identity and access management allow CMS to focus on what its stakeholders really want, namely a secure and seamless experience.

RW: Many states are beginning to take a ‘Cloud First’ approach to their application procurements, what advice do you have for states who are considering cloud services for their H&HS transformation efforts?

MS: All enterprises that embark on a cloud-first journey have to overcome deeply engrained phobias about the reliability and security of cloud-based services. They typically challenge the cloud vendors to prove that they are perfectly reliable and secure. That’s really the wrong question to ask. The enterprises should be asking themselves if they can deliver comparable services more reliably and more securely than the cloud vendors! The answer, almost invariably, will be “no” because cloud services are required to meet certain security standards. My second piece of advice is to achieve a critical mass of cloud-based services as quickly as possible. True business agility is realized when a combination of cloud-based services is used to deliver all or most of some type of business process. Adding only one or two cloud capabilities to an existing application architecture will not produce the transformational results that most enterprises are seeking. At the same time, these new cloud-based solutions can be accessed on demand, from anywhere in the world, as long as the person is an authorized user.

RW: From a maintenance and management perspective what advantages does this approach bring to an IT organization in the long term?

MS: Bringing on cloud applications and services will take an organization out of the business of buying hardware and operating data centers, and allows them to focus on delivering new and better services through an interface that is more intuitive, personalized and secure than anything they’ve offered in the past. Reliable infrastructure operations are presumptive table stakes to any customer or end user. The name of the game going forward is customer experience. Infrastructure maintenance responsibilities are, in effect, a distraction from delivering the business functionality and ease of use that end users are really seeking. Okta, and other cloud-based service providers, can relieve IT organizations of this distraction.

RW: Okta’s principal offering is branded as the ‘Okta Identity Cloud’, can this solution be integrated into any application environment?

MS: Absolutely. We think of the Okta Identity Cloud as the foundation for secure connections between people and technology. Okta is actually embedded in a variety of commercial services such as Adobe’s Creative Cloud and Ring Central’s unified communication products. Access to Adobe and Ring Central’s services is authenticated via Okta — without any interruptions to the user experience. Okta has a 100% API driven architecture which enables its integration into virtually any application environment. Additionally, Okta offers deep integrations to over 5,000 cloud and web-based commercial services via the Okta Application Network (OAN), making Okta the “easy button” for IT shops seeking to expand the use of cloud-based applications in the future.

Join Okta on:

“Centers for Medicare and Medicaid Services: Identity is key for a Secure, User-friendly Experience” on Tuesday, March 28, 3:45 p.m.
Register to Attend the 2017 State Healthcare IT Connect Summit | March 28th – 29th | Hilton Baltimore, Baltimore MD.


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Eugene Sayan, Softheon’s Chairman, CEO & Founder sat down with Healthcare IT Connect’s Rob Waters to discuss the expanding role of integration and analytics in a cloud and services based world and how Softheon feels it is uniquely positioned to thrive in this future landscape.

Rob Waters: Can you tell us about your company, Softheon, its corporate culture, and how that culture extends to the quality relationships you establish with clients?

Eugene Sayan: At Softheon we strive to create simple solutions to complex problems. We are headquartered in Stony Brook, NY and the majority of our workforce has graduated college within the last five years. What we lack in experience, we make up for in determination and focus. Our culture then isn’t just about working hard, but at its core it comes down to the relationships we build with each of our clients. We have been able to build these lasting relationships through open communication channels, collaboration, and an overall willingness to handle anything that comes our way. This is the reason we use the term ‘partner’ rather than ‘client’: our relationships are paramount, and all other activities are an extension of this fact.

RW: Can you give a more in-depth description on the services you provide to payers and governments and how you differentiate yourself. How does Softheon deliver value to solve their challenges?

ES: Softheon provides a variety of services to both payers and governments, including automated premium billing, payment gateway, HIPAA EDI validations, and advanced data analytics. Our platform is able to take data from a variety of disparate sources and converge into a meaningful repository, which can in turn streamline a number of ancillary processes. One of Softheon’s most valuable services (outside of the Software itself), that we provide to both payers and government agencies, has to be our agility. We differentiate ourselves from our competition by the fact that we have been able to adapt and thrive in a very unstable market.

RW: You previously forecasted that a supply chain transformation where healthcare payers would govern, rather than own, their data assets. Has this vision come to fruition?

ES: With regards to payers governing, rather than owning their data assets, we can already see this shift occurring by the fact that a number of payers are adopting cloud-based, value-added solutions. Payers now have less of a need for expensive hardware infrastructure, and can employ a leaner technical team.

At the same time, these new cloud-based solutions can be accessed on demand, from anywhere in the world, as long as the person is an authorized user.

RW: Where do see advanced analytics and integration going?

ES: We see advanced data analytics and integration becoming more and more prominent in the healthcare space, both for payers and government agencies. These analytics are already being used today for tasks such as plan design and target market outreach. The demand for real-time integrations is also becoming a more popular topic, as customers want their metrics as soon as they are available, and want their partners to be on the same page. We see this as building the healthcare ecosystem, which can then in-turn create a better system for all stakeholders.

Join Softheon on:

“HIX 2.0: Considering an Exchange Operator” on Tuesday, March 28, 3:45 p.m.

Register to Attend the 2017 State Healthcare IT Connect Summit | March 28th – 29th | Hilton Baltimore, Baltimore MD.

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Tom Graves, SVP State Government Solutions with Optum sat down with Rob Waters, VP & Program Director with HITC to discuss the company’s launch into the MMIS market, Optum’s services based approach and where this fits into the future of the Medicaid enterprise!

Rob Waters: There’s a buzz in the marketplace that says Optum is jumping into the MMIS market with both feet. Is that true?

Tom Graves: Yes, it is! However, our approach is new and different from past practices. We think states spend too much time focused on how their technology needs to work, and too little on how their program needs to be managed. It may be that Medicaid “systems” have historically held states back from modernizing and reforming their programs. But at Optum, we think there’s a better way. Our approach starts with a few basic premises:

1) Medicaid members and providers deserve similar care and support irrespective of how the state chooses to purchase it: either via capitation or fee-for-service (FFS).

2) There are many things that work effectively today in the managed care setting, such as claims administration, call centers, medical management and analytics that can be re-used in the FFS side of Medicaid.

3) States can get the support they need by purchasing services alone as opposed to building massive systems, which are then followed by purchasing services — it’s similar to buying electricity rather than designing and building a power plant.

4) Medicaid health plans should be considered as a source reference model for an approach that works for managing care since they sit in a position in the market today that most closely resembles that of a state: they take on medical cost risk for Medicaid recipients while delivering better care at a lower cost.

Our approach is a well-thought-out derivative of the same capabilities we use to help Medicaid health plans manage billions in medical cost every day.

RW: What does Optum think the Medicaid enterprise of the future looks like?

TG: All the changes states and CMS are trying to drive (such as modularity, MITA, etc.) are really about providing better services and outcomes at a better cost for people and for communities — that’s the Medicaid enterprise of the future. To do that, we recommend the following to states:

1) Shift the thinking from transaction-centric to data-centric.

2) Rationalize requirements to maximize the parallels to, and alignment with, commercial capabilities that already exist.

3) Stop buying technology that you don’t need and stop trying to use state Medicaid uniqueness to create a separate health care market vertical.

4) Deploy precious state program talent on managing and evolving policy that gets to your broader health care and cost objectives rather than using the resources to update systems and administer day-to-day claim transactions.

If states can do this, they will be able to tap into the heavy capital investment and innovations made by companies in the commercial health care industry, and then reap the benefits of more competition as a flood of new market entrants seek to help.

RW: What is required by states to adopt this “managed care derivative” approach for fee-for-service populations?

TG: States should procure modules, but procure them “as-a-service” or “business process as a service” (BPaaS) wherever possible, avoiding the system-build altogether. We understand it’s not exactly the same and it is a change, but in Medicaid managed care, states purchase similar services all the time — they’re just baked into the capitation rate. There are no systems to buy — not for claims processing, not for pre-authorization services, not for provider enrollment or any other business function. It’s all done “as-a-service.” The implementation is usually six months or less and that includes time to build out the network.

RW: How do you think this approach fits within the CMS definition of a modular MMIS?

TG: CMS has shown great flexibility in what constitutes a module. We find it interesting that most states, therefore, view a “module” as an MMIS “function” and see common definitions like provider enrollment, claims (or core) services, care management, etc., where each module is then integrated with the others via a systems-integration layer. Think of this approach as a horizontal slicing of MMIS requirements into modules. In this case, the state has essentially replicated the functionality required for their MMIS in multiple horizontal components, and therefore has multiple complex projects and vendors that have to cooperate and interoperate for a successful outcome.
What we’ve seen less of, but recommend states do more of, is to cut their MMIS requirements vertically — that is, by eligibility or service category, geography, or perhaps claim type such that all MMIS requirements are delivered for each vertical slice and then each vertical slice is integrated for core data needs. Nebraska is doing this with their residual FFS population; Massachusetts is doing something similar with their Long-Term Services and Supports (LTSS) program. And Montana did this some time ago with both their CHIP and Medicaid Expansion programs. With CMS documenting their willingness to certify this approach under “Administrative Services Only (ASO)” procedures through guidance issued last spring, there’s really no reason every state shouldn’t consider it.

RW: What are the other benefits states can receive with this paradigm shift to a services-based solution?

TG: With the Optum approach, which we call Optum Medicaid Management Services, the number-one benefit for states is that we truly put data at the center of Medicaid enterprise. We create an administrative environment for FFS that uses proven commercial capabilities for claims processing, etc., and then install a data analytics framework between them to ingest transactions and data from both worlds. In this framework resides an enterprise data warehouse that aggregates, organizes and enriches data for use in developing the program-wide insights and understanding needed to drive policy and program improvement and reform. This data analytics framework becomes the “system” for the state and transactional functions are performed through purchased services. Altogether, it’s a much simpler Medicaid administration model that is much less difficult to implement, operate and change as the program evolves over time. It is also ideally suited to do a better job of managing to better health care at lower costs. And since it leverages commercial services, new requirements for things like health savings accounts and beneficiary cost sharing coming to Medicaid are already baked in. There’s really no downside.
If states think creatively about how they can leverage this new CMS flexibility, we can collectively take Medicaid to a whole new level. And back to the original question about Optum jumping in, we collaborate with partners across the system to lead change in health care. It’s our mission to help make the health system work better for everyone. We’re anxious to do our part!

Join Optum and participating panel members on:

 “What Comes First? Implementing a 21st-Century Modular HHS Ecosystem” on Tuesday, March 28, 10:45 a.m., and

“What Does Your Future Look Like? Taking the Mystery Out of a Services-Based Approach” on Wednesday, March 29, 11:30 p.m.

Register to Attend the 2017 State Healthcare IT Connect Summit | March 28th – 29th | Hilton Baltimore, Baltimore MD.


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State Innovation, Data Analytics and Population Health Management Track (2)

2017 8th Annual State Health IT Connect Summit, March 28-29 in Baltimore


Moderator: Carol Robinson, Principal of CedarBridge Group LLC
Susan Otter, Director of Health IT, Oregon Health Authority
Mark Shaffer, PhD, Director of Healthcare Innovation, Connecticut Office of the Healthcare Advocate
Chris Underwood, Health Information Office Director, Colorado Department of Health Care Policy & Financing
Sheldon Wolf, Director of North Dakota Health Information Technology

Project Description/associated implementation: To meet the increasing demand for a technology-enabled healthcare ecosystem, states must navigate complex stakeholder relationships and gain consensus for financing strategies as well as governance of health IT assets. In many states, Medicaid agencies are tapping federal funds available through the HITECH Act to help finance the implementation of population health and data analytics tools. Working closely with private sector stakeholders and other state agencies is critical to maximize the available funding for the IT investments necessary for health transformation. CedarBridge Group proposes a panel focused on how diverse states are financing and governing health IT systems for population health management and analytics. This panel would be comprised of representatives from State Innovation Model (SIM) testing states (Colorado, Connecticut, and Oregon) and North Dakota, a state moving forward without the additional driver of SIM funding.

Target Audience for Discussion Group: State program managers, agency leaders in Medicaid agencies and state and county public health officials, and other state officials, hospital and health plan representatives, accountable care organizations (ACOs), and all types of healthcare organizations participating in alternative payment models (APMs), researchers, consultants and vendors.

Why the topic/project is at the leading edge of health IT, health and human services transformation Information exchange between health and social services systems is currently the exception, not the rule in communities across the country. However, states are planning for the future with the assistance of a generous, but time-limited funding source that was recently expanded by CMS and announced on February 29, 2016 in a State Medicaid Directors letter. States are working quickly to establish strategies to provide the required matching funds to draw down federal funds in order to implement technology that will enable better care coordination and quality measurement across healthcare providers and over time, with social services, justice systems, and community support organizations.

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore

Government Registration is Complimentary: 
Register your State, Federal, State Designated Entity (HIEs, HIXs, RECs, HIOs) Here 
Questions regarding planning for your team’s registration & attendance should be emailed to
Payers & Providers: Register your team to attend at the E. Bird Rate Here ($595), before Dec 9th.
Vendors: Register your team to attend at the E. Bird Rate Here ($695), before Dec. 9th.

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Healthcare IT Connect is currently planning a number of sessions at the 2017 State HIT Connect Summit, March 28-29 specifically to explore the policy and fiscal levers that could be utilized by the Trump administration to ‘repeal and replace’ or ‘modify’ the Affordable Care Act as well as to assess the likely impact on the State H&HS transformation programs including the funding for HIT and the modernization of Medicaid and integrated H&HS systems.

Transition sessions will include discussions on strategic planning issues including:

• Exploring the impact of replacement options for the Affordable Care Act, associated timelines and what this means for states?

• If Medicaid block granting is introduced, how could states sustain H&HS innovation efforts?

• What will Medicaid IT modernization look like and how could CMS’ Modularization Initiative be impacted?

• Will the A-87 Cost Allocation Exception exist beyond it’s current expiration in 2018?

• What will be the future for the State Innovation Model (SIM) Program?

• What will be the role for Value Based Care, could the MACRA Law be impacted?

• What support will be provided for Veterans populations and behavioural health integration/connectivity?

• What will be Trump administration’s approach to solving interoperability challenges and what will is the vision for the Health IT Policy and Standards Committees?

• Will there be a renewed focus on Telehealth and Remote Patient Monitoring?

• Cybersecurity – what direction will renewed focus take?

APHSA Releases Transition Report to President-Elect & Congress
The American Public Services Association (APHSA) released a Transition Report to President-Elect and Congress entitled ‘Creating a Modern and Responsive Health and Human Services System’ highlighting new approaches to H&HS transformation that are ‘innovative, efficient, effective and responsive to the needs of a rapidly changing society’. Click here to read the full paper.

APHSA is a strategic partner of Healthcare IT Connect in support of the 2017 State HIT Connect Summit, March 28-29 in Baltimore.

2017 State HIT Connect Summit, March 28-29

The 2-day program brings together public and private sector thought leaders to share ideas and benchmark implementation strategies of State health IT systems as they move forward with diverse health and human services transformation programs.

2017 Tracks

Track 1: Medicaid Modernization, Modularity and MMIS Procurement
Track 2: State Innovation, Data Analytics and Population Health Management
Track 3: Enterprise Systems Planning, Health and Human Services Integration
Track 4: Compliance, Security & Combating Fraud, Waste & Abuse

Who attends?
attendees from 42 states and territories attended in 2016
State: CIOs, CMOs, State HIT Coordinators
State Medicaid, Health and Human Services: Director, Health Reform, CMOs, CSOs, E&E, MMIS, MES, Provider Relations, Analytics, PHM, Sustainability
State Desiganted Entities (Health Information Exchanges (HIEs), HIOs (Health Information Organizations), APCD (All Payers Claims Database): CEO, Executive Director, CIO, CSO, Data Analytics and Product Management
Health Insurance Exchanges (HIX): CEO, Executive Director, CIO, CSO and MIS
Commercial Payers, Managed Care Organizations, Health Systems: CMIOs, Director HIE, Informatics, Population Health Management, Care Coordination
Solution Providers/Integrators: CEO, VP Public Sector, VP Sales, Director HIE / HIX, Project Directors, Account Managers
Learn more

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore:
Government Registration is Complimentary: Register your State, Federal, State Designated Entity (HIEs, HIXs, RECs, HIOs) Here Questions regarding planning for your team’s registration & attendance should be emailed to
Payers & Providers: Register your team to attend at the E. Bird Rate Here ($595), before Dec 9th.
Vendors: Register your team to attend at the E. Bird Rate Here ($695), before Dec. 9th.

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The Public Health Information Technology (PHIT) Maturity Index: Evaluating and Improving the Adoption and Use of PHIT

Enterprise Systems Planning, Health and Human Services Integration Track (3)
2017 8th Annual State Health IT Connect Summit, March 28-29 in Baltimore

Presenter: Teresa Rivera, President and CEO, UHIN Day 01 | 2:30:3:30 Tuesday, March 28th 2017

Project Description/associated implementation: This presentation will include a detailed study of a natural experiment enabled by the public health IT transformation efforts of Montgomery County, Maryland, a large suburban county. Montgomery County has been engaged in on-going efforts to improve public health services leveraging new IT systems. Notably, the Montgomery County Department of Health and Human Services (DHHS) and a public-private network of safety net clinics supported by the Primary Care Coalition of Montgomery County (PCC) embarked on the process of implementing an EHR that supports coordination across Social, Somatic, Dental and Behavioral Health Services. The EHR aimed to provide greater visibility of patient information across service areas and more efficient communication and management of information both internally and externally. Qualitative and quantitative data collection techniques were used. We conducted an intensive analysis of this EHR implementation across PCC and DHHS facilities (12), using interviews (61), observations (16), patient focus groups (3) and surveys (55.5% overall response rate) of EHR users before and after the EHR implementation, and client chart reviews (67), which provided a rich qualitative record. Staff participating in the study included DHHS and PCC clinical providers, administrative and client services staff, and managers at multiple levels across worksites including Access to Social and Health Services, Behavioral Health Programs, Public Health Clinics, and Public Health Dental Services. Patients included in this study typically received a mix of somatic, behavioral and social services through the health department. A detailed chart review was conducted to enable our understanding of the use, breadth, capability, interaction and usability of both legacy and existing systems. The experiences of implementing PHIT and the factors important to successful value realization were distilled and assessed for Index inclusion. Survey data was analyzed using factor analytic strategies to assess the reliability and validity of subscales and their conceptual structure, and t-tests and multivariate regression provided inferential insights. The factor analysis included components relating to pre and post-implementation staff perceptions of: Information Gaps; EHR Impacts; Perceived Usefulness; Perceived Ease of Use; Future Use Intentions; Knowledge about System; and Training. The factors in combination with controls for demographics, employment history, and computer literacy were used in the regression models.

Further, a Delphi exercise was conducted with six experts representing public health systems at the state and local level and multi-stakeholder national groups. The Index design, narrative and corresponding questionnaire received written feedback, followed by a virtual focus group to obtain further feedback. Experts were asked to provide feedback on how instructive and measureable Index elements were, which elements needed to be added, changed or removed, and how to best design the Index to reflect macro and micro-level areas of importance. After the virtual focus group, a refined model was distributed for a concluding round of written comments, which were incorporated into the final PHIT Maturity Index.

Background: Public health information technology (PHIT) has the potential to improve the effective and efficient use of information in achieving public health objectives. Information technology maturity models have been extensively used in other domains to guide information technology assessment and planning, but an information technology maturity model tailored for public health departments has heretofore been unavailable.

Purpose: The purpose of this study was to develop a Public Health Information Technology Maturity Index.

Methods: An extensive literature review and content analysis was conducted of information system adoption, use, and maturity in general and in the public health systems and services research context in particular. Primary data were collected through staff interviews (61), staff observations (16), patient focus groups (3), and staff surveys (3) over the course of a multi-year technology implementation, including pre- and post-implementation of an electronic health record system at a large suburban public health department. Data were analyzed using qualitative and quantitative methods to extract potential categories for inclusion in the index. A Delphi exercise whose panelists included experts from state and local public health departments and national multi-stakeholder groups was conducted.

Results: A Public Health Information Technology Maturity Index, questionnaire, and scoring guide were created. The Maturity Index consisted of four primary categories: Scale and Scope of PHIT Use; PHIT Quality; PHIT Human Capital, Policy and Resources; and, PHIT Community Infrastructure, along with fourteen subdimensions. Implications: The PHIT Maturity Index represents a practical approach to aid public health system stakeholders, notably health departments, in the evaluation of their information technology deployment decisions. As benchmark data become available, it will enable comparative assessment and possible linking of information technology maturity and multi-agency interoperability to population health outcomes.
Research article details at: Video brief about the research:

Target Audience for Discussion Group: Information Technology leadership responsible for public health, e.g. State and Public Health Department Information Technology Management.

Why the topic/project is at the leading edge of health IT, health and human services transformation Medical records should follow a patient no matter where the patient is in the care continuum. This includes geographic boundaries. Recognizing the cross border care sought by those living near state lines and travelers, UHIN, the state-designated HIE in Utah, has partnered with the HIEs in Arizona and western Colorado to share ADTs when patients living in one HIE have a medical encounter at a facility participating in an HIE in another state. In the few months since ADTs began being sent across state lines, more than 4,000 have been sent. SUCCESS STORY: A Colorado pathologist was notified his patient had been admitted to a Utah hospital, and through his own HIE was able to access the Utah-generated CCD. From the CCD he was able to review the patient’s lab work, and use it as a baseline for the follow up care, ensuring far better coordinated care.

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore

Government Registration is Complimentary: Register your State, Federal, State Designated Entity (HIEs, HIXs, RECs, HIOs) Here Questions regarding planning for your team’s registration & attendance should be emailed to
Payers & Providers: Register your team to attend at the E. Bird Rate Here ($595), before Dec 9th.
Vendors: Register your team to attend at the E. Bird Rate Here ($695), before Dec. 9th.

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The Medicaid Technology Alliance: Implementing the Final 90/10 MMIS Regulation

Medicaid Modernization, Modularity and MMIS Procurement | Track (1)   

Project/associated implementation Description: In December 2015, the Centers for Medicare and Medicaid Services (CMS) issued the Mechanized Claims Processing and Information Retrieval Systems (90/10) Final Regulation. The new rule not only makes the availability of enhanced funding for eligibility and enrollment (E&E) and Medicaid Management Information Systems (MMIS) permanent, but it also allocates additional funding for commercial off-the-shelf solutions (COTS) and software as a service (SaaS) modular products rather than complete systems, which provides an opportunity for new technology vendors to enter the Medicaid technology space.

There are significant questions from states, vendors, and consultants regarding how to effectively implement and meet the requirements of the rule including: how to develop new procurement vehicles, how to effectively define the business and technical components of the modules, the requirements that will be needed for better interoperability and re-use between services and products, API development, module pre-certification, opportunities for new product vendors, and more. Given these needs and a desire not to compete with existing efforts, many feel there is a need for a higher-level strategic discussion regarding how to meaningfully and efficiently advance these concepts. 

In 2016, Leavitt Partners, NESCSO, and CMS convened multiple state, vendor, and consulting representatives to discuss the formation and next steps for a Medicaid Technology Alliance. The goals of the meetings were to: discuss common challenges in moving towards modular technology adoption, how to organize around key themes and workgroups, and determine a vision for the future of Medicaid technology.

This presentation will provide an update on the Alliance’s progress to date, how other states and interested parties can get involved, and describe the alliance’s vision for the future.

Target Audience for Discussion Group: State Medicaid technology leadership, State Medicaid Directors, Medicaid technology vendors, and consultants

Proposed Speaker Candidates:

Ryan Howells, Principal, Leavitt Partners
Jess Kahn, Director Data of Data and Systems Group, CMS
Julie Boughn, Audacious Inquiry, LLC; former Deputy Director, Center for Medicaid and CHIP, CMS
Charlene Frizzera, Senior Advisor, Leavitt Partners; former Acting Administrator for CMS
Frederick Isasi, National Governors Association
Chris Underwood, Director, Health Information Office, Colorado Department of Health Care Policy and Financing – HCPF
Stuart Fuller, Chief Information Officer, Montana Department of Public Health and Human Services
Tom Jordan, Chief Information Officer, State of New Jersey
Sarah Miller, Chief Operating Officer for Technology, Oregon Department of Human Services

Registration is now open for the 2017 8th Annual State HIT Connect Summit, March 28-29 in Baltimore

Government Registration is Complimentary: 
Register your State, Federal, State Designated Entity (HIEs, HIXs, RECs, HIOs) Here
Questions regarding planning for your team’s registration & attendance should be emailed to
Payers & Providers: Register your team to attend at the E. Bird Rate Here ($595), before Dec 9th.
Vendors: Register your team to attend at the E. Bird Rate Here ($695), before Dec. 9th.


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