Magazine article Policy & Practice

What Can Medicaid Agencies Learn from the Auto Industry?

Magazine article Policy & Practice

What Can Medicaid Agencies Learn from the Auto Industry?

Article excerpt

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.

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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 intemperate. In the MMIS environment, the platform is a multi-tiered, 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-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 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 Some are practically outdated the same day they go live.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. …

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