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MESC 2018 reflections–Portland, Oregon

08.21.18

Do we now have the puzzle pieces to build the future?

As I head home from a fabulous week at the 2018 Medicaid Enterprise Systems Conference (MESC), I am reflecting on my biggest takeaways. Do we have the information we need to effectively move into the next 12 months of work in the Medicaid space? My initial reaction is YES!

The content of the sessions, the opportunities to interact with states, vendors, and the Centers for Medicare and Medicaid Systems (CMS) representatives were all rich and rewarding.

The underlying message from Julie Boughn, the CMS Director Data and Systems Group? This is “The Year of Data Quality” and the focus will be migrating to outcomes-based projects. CMS indicated they would like their regional representatives and state agencies to be aware of their top three priorities, focus on those, and be able to exhibit measurable progress in the next year.

Here are three ways states can focus their efforts in "The Year of Quality":

  1. Fix identified areas that have issues (every state has T-MSIS areas they can correct)
  2. Maintain data quality over time, especially through system enhancements
  3. Be aware of CMS plans to use and share T-MSIS data

CMS’ overall goals and vision for improvement include:

  • Creating faster delivery of well-functioning capabilities
  • Improving user experience for all users: produce timely, accurate, and complete data
  • Better monitoring and reporting on business process outcomes

I interpret Julie Boughn’s message and direction to be: keep our efforts realistic, focus on tangible results/outcomes, and realize that CMS is approachable.

While we work on outcomes, there may be some additional changes coming to the certification approach—even beyond the most recent updates from CMS. I think there is general understanding that the work we do in the Medicaid space is iterative, and we will always be improving and changing to adapt to the shifting environment and needs of our beneficiaries, stakeholders, and administration.

As I commuted on Portland’s MAX rail line between my hotel, the conference venue, and other events, I remembered Portland’s 2010 conference (then known as the MMIS Conference) and how the topics covered then and now are evidence of just how much we have evolved.

First, we were the MMIS Conference—now there is a much broader view of the Medicaid arena and our attention is on the Medicaid Enterprise—which includes the MMIS.

Second, in 2010 the nation was coming out of the Great Recession and there was a significant amount of energy spent on implementing initiatives on the American Recovery and Reinvestment Act (ARRA). With it came a host of initiatives: meaningful use, as it related to incentives for providers to utilize electronic health records, states were subsequently updating their Medicaid IT and information exchange plans, and ICD-10 implementation readiness was a hot topic.

Fast forward to 2018, where session topics included modularity, re-use, health outcomes, coordinated care, data quality measures, programs to improve and enhance care, the opioid epidemic, long-term care, care delivery systems, payment, and certification measures. The general focus has migrated to include areas far beyond technology and the MMIS.

As we move into the next 12 months of work in the Medicaid space and look forward to gathering in Chicago for the 2019 MESC, the answer is YES, we have a clear direction and vision for moving forward. And we know things will continue to change in coming years. Are you ready to reassemble the pieces to fit and build the evolving picture of Medicaid?

The MESC “B’more for healthcare innovation” is now behind us. This annual Medicaid conference is a great marker of time, and we remember each by location: St. Louis, Des Moines, Denver, Charleston… and now, Baltimore. The conference is not only a way to take stock of where the Medicaid industry stands. It is a time to connect with the state and vendor community, explore challenges and best-practice solutions, and drive innovation with our respective projects.

Having an opportunity to reflect on MESC over the last several years, I’ve discovered that taking stock of how much has changed (or not) is a valuable exercise. 

Changes at CMS

At the federal level, there is the departure of a long time contributor — Jessica Kahn — who is no longer with CMS. Her contributions and absence were marked in both the opening and closing plenary. We are grateful for her dedication and many contributions to the Medicaid space. In this time of change, we look forward to continuing our work with CMS leadership CMS to advance the mission of Medicaid.

Innovation and Collaboration

Many of the sessions this year were updates on modularity, system integration, and certification, and sessions on expanding or maturing innovative approaches to achieving our triple aim. While there did not seem to be any earth-shattering changes, calls for innovation and collaboration continue. This can be difficult to achieve during a time of anticipated change, but necessary, as states strive to realize improvements in their systems and operations.

Data-Driven Decisions

One of the dominating conference themes was a reiteration of the need to access data from broad sources within and outside Medicaid, and to leverage that data for policy and operation-related solutions and decision-making. Key words like “interoperability” and “sustainability” could be heard echoing through the halls. There is no one-size-fits-all solution on how to break out of stove pipes of data, but some new technologies may be viable tools to meet the challenge. 

Strategic Planning for the Future

States remain focused on refining and following their strategic plans and roadmaps in a time of uncertainty — with regard to potential changes coming from the federal level. The closing plenary suggested that states be prepared for “local leadership” opportunities, which further underscores the need for states to continue to prepare themselves and their systems to facilitate changes to their programs.

Maintaining Perspective

As I leave Baltimore to return home and help care for my 88-year-old father, and as I see others who are in clear need of healthcare help, I am reminded that the work we do and the problems we are tackling are important on so many levels. It is a cornerstone of the well-being of our health system and our fellow citizens. Our team will continue to focus our efforts with this perspective in mind, drawing from the lessons, discussions, and best practices shared at this year’s MESC.

Here’s to a year of good health — may you successfully carry out the mission of Medicaid in your state. See you in 2018 in Portland, Oregon!

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Reflections on MESC 2017

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