Missouri’s $147M Medicaid Modernization, An Interview with EngagePoint’s David Smith
EngagePoint was recently awarded the prime contract for Missouri’s Human Services’ IT transformation efforts, David Smith is Engagepoint’s executive sponsor providing oversight for the project. David sat down with Rob Waters, Program Director with Healthcare IT Connect to take a deeper dive on some of the implementation goals, deliverables as well as the opportunity for Missouri to benefit from similar systems EngagePoint is designing in Arkansas, Minnesota and Maryland.
ROB WATERS: David, can you explain your role as the executive sponsor for the State of Missouri project. Is this unique to Missouri and why is the role important?
DAVID SMITH: Simply put, my role as executive sponsor is to see that the overall objectives of the state are achieved and the needs of all its constituents are met – not just for the immediate project, but to assure that the solution we’re developing has the capability, the flexibility to support the needs of the state and its citizens for the long term.
RW: Can you tell us about EngagePoint’s experience working with other states on their HIX and Medicaid transformation? What have been some of the lessons learned, technology transfers that MO could benefit from?
DS: EngagePoint is working with five states in roles ranging from architecting, designing and implementing new health insurance marketplaces, to modernizing Medicaid eligibility systems, to, in one case, providing implementation support directly to that state’s integrated project management office.
One key benefit EngagePoint brings is the experience and expertise we’re continuously accumulating. We’re able to leverage our understanding and knowledge and bring the methodologies and artifacts that have already been created. It comes down to reusability. By being able to reuse artifacts, code, methodology, processes, and governance models, we’re able to reduce the time to implement solutions that address current needs with a flexible, sustainable platform that will be able to support future requirements.
RW: Can you give us an overview of the work that EngagePoint will be doing with MO as the systems integrator and who are the other major vendors involved?
DS: Our role as system integrator is to provide the foundation on which the entire solution is built and which enables all of the individual components or COTS products to work together seamlessly – to interoperate and perform as a single solution – for citizens to determine eligibility and enroll in the state’s social services programs.
For the state of Missouri, the key components we’re bringing together are IBM’s Cúram software for Medicaid eligibility determination, a Medicaid plan presentment and selection solution, and EngagePoint Financials for Medicaid premium billing and reconciliation.
RW: From an operational perspective, what is EngagePoint putting in place to support the contract. Are there specific governance and management models you’re following?
DS: We are able to re-use proven methodologies and models from other projects. Project governance is key, and we have developed a governance model that provides the state visibility, traceability, and accountability for all decisions.
RW: Is there a specific methodology or approach that EngagePoint has found to be more effective for fixed scope, fixed timeline projects of this type?
DS: If there’s a common theme here, it’s “reusability.” Reusability is key. Being able to leverage our knowledge and work from other projects enables EngagePoint to reduce the time to deliver. It’s what’s allowing us to meet these aggressive timelines.
RW: Once States have completed major build projects in support of E&E, case management and data sharing, how do you envisage they will begin to utilize this infrastructure to serve citizens improve care coordination as reform is implemented?
DS: The legacy systems we’re replacing in many cases are more than 25 years old. Most operate in a mainframe environment. They don’t allow real-time interaction for citizens or caseworkers to access information, get answers to their questions, or determine eligibility.
We see states leveraging the infrastructure we’re developing to improve their efficiency, effectiveness, and the quality of service they’re delivering. Ultimately we see states leveraging this infrastructure to empower individuals through self-service models that offer rapid access to information, answers to their questions, and the ability to directly enroll in the program they’re eligible for.