Policy and Practice October 2011 : Page 29

technology speaks By Chris Mirro A utomakers invest in a single plat-form as the design and engineer-ing foundation to conﬁ gure diff erent models. This shared chassis helps the industry streamline and speed pro-duction. With a platform approach to Medicaid Management Information System (MMIS) implementation, states, too, can stop reinventing the wheel and develop ﬂ exible systems that evolve with—and ahead—of change. In today’s Medicaid environment, states must achieve their missions in an environment in ﬂ ux—from health care reform and legislative mandates to expansions in covered populations and changes in the role of managed care. What’s more, they must do so amid intense public and legislative scrutiny to lower costs while improving patient outcomes. As in the automobile industry, a plat-form approach is a conﬁ gurable solu-tion that meets diverse needs. Diff erent engines, diff erent bodies, diff erent conﬁ gurations, even diff erent brands of cars are built upon common plat-forms. The platform provides for all the connections and interfaces and is the framework upon which all the other parts can interoperate. In the MMIS environment, the platform is a multi-tiered, service-oriented architecture layered with a series of preconﬁ gured commercial, off -the-shelf products that deliver complete business functionality to meet MMIS requirements—claims processing, provider management, ben-eﬁ ciary management, managed care integration, health outcomes manage-ment, and payment and health care reform. Building a new MMIS is not easy. Building a new MMIS in an environ-ment of constant change is even more diffi cult. In today’s environment, con-tinuing to approach this daunting task in the same ways will not yield better results. States have struggled to get ahead of change. Many are stuck in a cycle that makes innovation diffi cult. They are implementing the same costly, slow-to-market MMIS systems again and again. Implementations over the last several years have been late, over budget and have failed to improve upon their pre-decessors. Some are practically out-dated the same day they go live. It is clear that state Medicaid agen-cies need a completely diff erent approach to MMIS implementation. They need systems that are ﬂ exible and can adapt to what the future may hold, without costly upgrades or end-less reinvention loops. Based on my understanding of Medicaid and public meets today’s requirements and that can adapt to future changes. In addition to adaptation, states can realize many other valuable beneﬁ ts. They can develop comprehensive MMIS functionality faster and at lower risk through proven components and pre-built functionality. States will be able to reduce the burden on staff related to review cycles for system changes and eliminate the need for multiple, com-plex change orders. They will enable their teams to allot more money, time and energy to focus on the mission. The foundation can be extended across other state public health administra-tion programs. Aligning with Medicaid Information Technology Architecture What Can Medicaid Agencies Learn from the Auto Industry? health administration—and the suc-cess of similar platform approaches in human services and enterprise resource planning—I believe that a platform approach to MMIS implementation is the only way for states to “future proof” their Medicaid infrastructure. Leveraging a platform, however, means you have to think, design and purchase diff erently. It means projects need to focus on implementation of solutions that exist, rather than on cre-ating and customizing software that is being transferred (conﬁ guration rather than customization). It means that soft-ware is licensed and not owned. And, it means that business processes change to work with the new platform, rather than “breaking” the platform to force the support of an old process. Using a platform approach is a disci-plined approach to MMIS implemen-tation that will help states move from a proactive to a reactive position that drives lasting value. They can develop, maintain and operate an MMIS that requirements and the Centers for Medicare and Medicaid Services’ Seven Conditions and Standards for Enhanced Funding can be done more effi ciently and eff ectively. Moreover, the move toward clinical data sharing and interoperability can be streamlined. It’s a common-sense solution to a complex process. Ultimately, the platform’s viability will rest on states’ breaking from the status quo. Future prooﬁ ng their Medicaid infrastructure with a platform-based system will begin with states taking action to change their procurement focus from “how” it must be done to “what” must be done. With a focus on the desired end state, states will encourage industry to respond by bringing the best in innova-tion, and results, to market. Chris Mirro is a senior executive at Accenture Health and Public Service. October 2011 Policy & Practice 29

Technology Speaks

Chris Mirro

What Can Medicaid Agencies Learn from the Auto Industry? Automakers invest in a single platform as the design and engineering foundation to configure different models. This shared chassis helps the industry streamline and speed production. With a platform approach to Medicaid Management Information System (MMIS) implementation, states, too, can stop reinventing the wheel and develop flexible systems that evolve with-and ahead-of change. In today's Medicaid environment, states must achieve their missions in an environment in flux-from health care reform and legislative mandates to expansions in covered populations and changes in the role of managed care. What's more, they must do so amid intense public and legislative scrutiny to lower costs while improving patient outcomes. As in the automobile industry, a platform approach is a configurable solution that meets diverse needs. Different engines, different bodies, different configurations, even different brands of cars are built upon common platforms. The platform provides for all the connections and interfaces and is the framework upon which all the other parts can interoperate. In the MMIS environment, the platform is a multitiered, service-oriented architecture layered with a series of preconfigured commercial, off -the-shelf products that deliver complete business functionality to meet MMIS requirements-claims processing, provider management, beneficiary management, managed care integration, health outcomes management, and payment and health care reform. Building a new MMIS is not easy. Building a new MMIS in an environment of constant change is even more difficult. In today's environment, continuing to approach this daunting task in the same ways will not yield better results. States have struggled to get ahead of change. Many are stuck in a cycle that makes innovation difficult. They are implementing the same costly, slow-tomarket MMIS systems again and again. Implementations over the last several years have been late, over budget and have failed to improve upon their predecessors. Some are practically outdated the same day they go live. It is clear that state Medicaid agencies need a completely different approach to MMIS implementation. They need systems that are flexible and can adapt to what the future may hold, without costly upgrades or endless reinvention loops. Based on my understanding of Medicaid and public health administration-and the success of similar platform approaches in human services and enterprise resource planning-I believe that a platform approach to MMIS implementation is the only way for states to "future proof" their Medicaid infrastructure. Leveraging a platform, however, means you have to think, design and purchase differently. It means projects need to focus on implementation of solutions that exist, rather than on creating and customizing software that is being transferred (configuration rather than customization). It means that software is licensed and not owned. And, it means that business processes change to work with the new platform, rather than "breaking" the platform to force the support of an old process. Using a platform approach is a disciplined approach to MMIS implementation that will help states move from a proactive to a reactive position that drives lasting value. They can develop, maintain and operate an MMIS that meets today's requirements and that can adapt to future changes. In addition to adaptation, states can realize many other valuable benefits. They can develop comprehensive MMIS functionality faster and at lower risk through proven components and prebuilt functionality. States will be able to reduce the burden on staff related to review cycles for system changes and eliminate the need for multiple, complex change orders. They will enable their teams to allot more money, time and energy to focus on the mission. The foundation can be extended across other state public health administration programs. Aligning with Medicaid Information Technology Architecture requirements and the Centers for Medicare and Medicaid Services' Seven Conditions and Standards for Enhanced Funding can be done more efficiently and effectively. Moreover, the move toward clinical data sharing and interoperability can be streamlined. It's a common-sense solution to a complex process. Ultimately, the platform's viability will rest on states' breaking from the status quo. Future proofing their Medicaid infrastructure with a platform-based system will begin with states taking action to change their procurement focus from "how" it must be done to "what" must be done. With a focus on the desired end state, states will encourage industry to respond by bringing the best in innovation, and results, to market.

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