States work­ing to meet 2014 dead­line to up­grade IT for Med­i­caid

States work to up­grade IT to meet 2014 dead­line

Modern Healthcare - - MODERN HEALTHCARE - Rich Daly

Al­though more than half of the states are su­ing to get out of a mas­sive Med­i­caid ex­pan­sion un­der the fed­eral health­care over­haul, most also are work­ing to over­come a key ob­sta­cle to grow­ing their pro­grams.

The Pa­tient Pro­tec­tion and Af­ford­able Care Act re­lies heav­ily on broad­en­ing el­i­gi­bil­ity in the joint fed­eral and state pro­gram be­gin­ning in 2014 in or­der to ex­tend health cov­er­age to most Amer­i­cans. The re­quired Med­i­caid ex­pan­sion also faces a con­sti­tu­tional chal­lenge by 26 states on which the Supreme Court will de­cide by the end of its ses­sion in June. Those states main­tain that the law cre­ates an un­con­sti­tu­tional cost bur­den on their states be­yond the fed­eral gov­ern­ment’s ini­tial cov­er­age of the cost of the new Med­i­caid en­rollees.

If it stands, the Med­i­caid ex­pan­sion will pro­vide not only half of the es­ti­mated 32 mil­lion peo­ple pro­jected to gain cov­er­age un­der the law but also crit­i­cal sup­port to the func­tion­ing of state health in­sur­ance ex­changes, through which the other 16 mil­lion peo­ple are ex­pected to ob­tain cov­er­age un­der law, ac­cord­ing to Con­gres­sional Bud­get Of­fice pro­jec­tions.

But the growth in Med­i­caid and the sup­port those pro­grams are ex­pected to pro­vide to the ex­changes de­pend on the abil­ity of states to up­grade the pub­lic in­sur­ance pro­grams’ some­times decades-old tech­nol­ogy.

“Most of the cur­rent el­i­gi­bil­ity sys­tems are of­ten a part of the old cash as­sis­tance pro­grams, and they are very much older sys­tems, of­ten legacy sys­tems and have not been de­signed for the new world of en­gag­ing con­sumer-cen­tric health­care de­liv­ery,” said Pa­tri­cia Mac­tag­gart, a lec­turer at Ge­orge Washington Univer­sity and the for­mer di­rec­tor of the Min­nesota Med­i­caid pro­gram.

The ex­act sta­tus of those tech­nol­ogy up­grades and whether states will fin­ish them by 2014 re­main un­clear, ac­cord­ing to health pol­icy ex­perts fol­low­ing the is­sue. But re­cent ev­i­dence in­di­cates most states—in­clud­ing some of those in the Med­i­caid law­suit—at least are try­ing to en­act such up­grades.

For ex­am­ple, 18 states have re­ceived CMS ap­proval and fund­ing for Med­i­caid IT sys­tem up­grades to help de­ter­mine el­i­gi­bil­ity and aimed at al­low­ing states to meet the 2014 re­quire­ments of the re­form law, ac­cord­ing to a re­cent an­nual Med­i­caid re­port by the Kaiser Com­mis­sion on Med­i­caid and the Unin­sured. An­other 10 states and Washington, D.C., have sub­mit­ted Med­i­caid IT up­grade plans to the CMS.

The in­creas­ing in­ter­est in that par­tic­u­lar com­po­nent of Med­i­caid health IT up­grades is driven in part by the of­fer of time-lim­ited fed­eral fund­ing. The re­port, based on sur­veys of state Med­i­caid of­fi­cials, found 19 more states ex­pect to par­tic­i­pate be­cause of the in­crease in fed­eral match­ing funds from 50% to 90% of the cost of ma­jor Med­i­caid en­roll­ment-re­lated tech­nol­ogy up­grades be­fore 2015.

“What you’re see­ing from the re­port is how many states are mov­ing fast to try to get their sys­tems in or­der,” Sa­man­tha Ar­tiga, one of the re­port’s au­thors, said when asked how the find­ings re­late to the 2014 en­roll­ment ex­pan­sion.

States also have un­der­taken an elec­tronic data

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.