States planning to replace their Medicaid claims systems should consider adding health information technology to the applications they fund in order to take advantage of federal programs that reward investment in health care infrastructure.
That was one of several suggestions speakers offered on how to tap public funding streams for health IT in a Webcast June 1 on health IT and Medicaid. It was sponsored by the National Conference of State Legislators and the National Governors Association Center for Best Practices.
Anthony Rodgers, director of Arizona’s Health Care Cost Containment System, said states should also take advantage of “transformation grants” offered by the Health and Human Services Department to spur state adoption of health IT. HHS has already awarded $103 million in the first round of transformation grants; a second round, announced in April, is currently under way.
“You have the opportunity to get not only transformation grants but federal matching funds if you configure your system in conjunction with your claims system,” Rodgers said during the audio conference. The session was produced by the State Alliance for e-Health, a federally funded organization devoted to helping states focus on national health care issues.
Rogers advised state legislators, Medicaid administrators and policy-makers to take advantage of a mix of sources for financing Medicaid and health care IT. He said they should:
Make sure state health IT projects meet standards in the Medicaid Information Technology Architecture (MITA), an initiative led by HHS’ Centers for Medicare and Medicaid Services. “If a state is building its product to meet the MITA standards, there is greater opportunity for federal participation,” Rodgers said.
Pursue a combination of funding sources, including Medicaid, public health grants and even user fees. “States should consider combining some of these other funding sources to finance these exchanges and electronic health records,” he said.
Consider requiring state Medicaid managed-care organizations to participate in electronic health exchanges and to provide EHRs.
Maximize employee health benefit programs. Some states have combined Medicaid with managed-care organizations for their employee health programs, creating opportunities to fund EHR systems. “There are opportunities to leverage employee health programs” for EHRs, Rodgers said.
Agree to a common set of standards for state Medicaid programs. “We already have the federal guidelines…it’s just a matter of pulling together and agreeing to a set of standards on how we will exchange data between states,” Rodgers said. Doing so will “significantly improve the Medicaid program's ability to take a leadership role in interstate exchange of information.”
Rodgers said 12 states that have received HHS transformation grants — Alabama, Arizona, Connecticut, Hawaii, Kentucky, Michigan, Mississippi, Montana, New Mexico, Texas, West Virginia and Wisconsin — and Washington, D.C., have banded together to collaborate on health IT project coordination, standards harmonization and joint planning.
“We want to establish a common vision for Medicaid agencies as it relates to health information,” he said. “It’s new technology, new requirements and new functions that many states are now taking on.… We wanted to make sure we have the greatest opportunity to assure success of the investment the federal government is making.”
Shaun Alfreds, an analyst at the University of Southern Maine’s Institute for Health Policy, said Medicaid beneficiaries are distinct from commercial insurance clients because they often have chronic diseases and behavioral health issues, and they drop in and out of the health care system.
These characteristics present states with significant challenges, Alfreds said, for which health IT and health information exchanges deliver a disproportionate benefit compared to commercial populations.
“The widespread adoption of health IT may contribute to improvements in health care quality and health outcomes for Medicaid populations,” Alfreds said. Benefits include more efficient tracking of claimants as they move in and out of eligibility and between providers.
Fraud and abuse controls are another big pay-off health IT can deliver in the Medicaid arena, Alfreds said.
But significant challenges remain for states in the adoption of health IT for Medicaid programs, including a mixed rate of adoption of CMS’ MITA project.
“It was a very large project, and multiple stakeholders were involved,” Alfreds said. But to date, “there haven’t been any regulations for Medicaid agencies…so there’s an issue of how do we modernize Medicaid Management Information Systems so that they can communicate with the external IT systems and with provider sites.”
Government Health IT will present Liesa Jo Jenkins, executive director of CareSpark, in an eSeminar at 11 a.m. Thursday, Oct. 16, where she will share her experiences and insight into building a health information exchange that enhances community health, rewards regional collaboration and drives economic progress.
