Accelerating Industry Participation in the Modular MMIS HHS Ecosystem

Date: March 31, 2016||   0  Comments


As more states join in expanding modularity, the health information technology community is trying to bring in more tech companies and vendors to identify entrance barriers. Members of what was dubbed the “Jedi panel,” taking on a “Star Wars” theme, discussed key points regarding stakeholder participation in modular MMIS modernization and health and human services ecosystem. Here’s what the experts had to say at the 2016 State Healthcare IT Connect Summit:

Developing an understanding
A major component of stakeholder participation is clarifying each state’s understanding of modularity. According to Kay Hallawell, the senior solution director at Optum Government Solutions, with Medicaid, there’s no one-size-fits-all package for states. These regions need to understand how their modules work to determine what they need. Pradeep Goel, chief executive officer of EngagePoint, said that a consistent definition helps states avoid a guessing game.

Defining modularity
Jessica Kahn, director of the data and systems group of the U.S. Centers for Medicare & Medicaid Services, emphasized that the CMS released a final rule outlining the specifics of modularity. The regulatory definition of modularity is the grouping of live business processes. This minimizes the impact from changes to individual units.

Goel discussed how boundaries are an integral component of modules. He encouraged the audience to think of modules as functional encapsulations driven by business needs. Modular formatting is necessary to upgrade or replace the different facets without impacting adjacent modules. To do this, they need well-defined boundaries.

State flexibility
While modules have certain necessary components, there is still room for flexibility on a state-by-state basis, Kahn explained. There are three main options when it comes to how states group processes.

• Grouping as traditionally done in MMIS.
• Maps to Medicaid Information Technology Architecture.
• The state’s own choice.

Furthermore, Kahn noted that the CMS is not defining modularity for the state but rather the modules’ functionality. The definition is there to support business processes.

What is consistent across the board, though, is certification criteria that support each business process. The underlying functions of each module are going to be the same. This balance allows vendors to practice innovation and states to be both consistent and flexible.

System integration
Panel members expressed that the system integrator must be present at the beginning of the process to identify potential risk and pitfalls. Kahn likened this component of health IT to the overarching metaphor of building a house. A general contractor wouldn’t put up walls before calling in an electrician. Similarly, a state shouldn’t develop solutions without a system integrator’s input.

As another first step, businesses must establish their needs before turning to technology solutions. Otherwise, there’s no telling if the innovation will actually serve a meaningful purpose.

Subscribe to View the HD Video Presentation |  The Force Awakens: Accelerating Stakeholder Participation in the Modular MMIS HHS Ecosystem

Robin Chacon, Healthcare & Human Services Practice Director, CSG Government Solutions
Ron Baldwin, CIO, State of Montana
Jessica Kahn, Director Data & Systems Group, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Kay Hallawell, Sr. Solution Director, Optum Government Solutions
Chris Lunt, VP Engineering, GetInsured
Pradeep Goel, CEO, EngagePoint
Chris Greene, Associate Vice President, Business Architecture, Molina Medicaid Solutions, Molina

To learn more about opportunities to participate at the 2017 State HIT Connect Summit, please email Victoria Smith, Communications Director, Healthcare IT Connect

2016 State Healthcare IT Connect Summit

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