Magazine article Policy & Practice

How You'll Modernize HHS System

Magazine article Policy & Practice

How You'll Modernize HHS System

Article excerpt

According to the Government Accountability Office (GAO), the federal government spends $80 billion a year on IT, much of which goes toward maintaining legacy IT systems. Decades-old hardware is a major problem for state and local governments as well. HHS decision-makers in our 2016 HHS survey said outdated IT systems and their corresponding issues were one of their most critical challenges --exacerbated by the fact that 75 percent of them reported that demand for their services has increased.

But there is some good news. The federal government, recognizing this urgent need for system modernization, continues to provide enhanced funding and more flexibility around how federal dollars can be used on systems that support multiple programs. It's also adjusting rules to promote modular deployments and cloud-based approaches.

What You Told Us:

What IT systems do you plan to modernize in the next 12 to 18
months?

HEALTH INFORMATION EXCHANGE                 23%
MEDICAID MANAGEMENT INFORMATION SYSTEMS     22%
INTEGRATED ELIGIBILITY SYSTEM               22%
STANDALONE ELIGIBILITY ENROLLMENT SYSTEMS   20%
CHILD WELFARE SYSTEM                        20%
CHILD SUPPORT ENFORCEMENT SYSTEM            11%
WIC MANAGED INFORMATION SYSTEM               8%
PRESCRIPTION DRUG MONITORING SYSTEM          6%

Note: Table made from bar graph.

39 PERCENT OF RESPONDENTS TO THE CDG/GOVERNING INSTITUTE HHS SURVEY SAID OVER 50% OF THEIR AGENCY'S IT SYSTEMS NEED TO BE MODERNIZED.

WHY YOU'LL BUILD DIFFERENTLY

The systems used to support evolving HHS programs will look much different than the technology they replace. Legacy HHS systems typically were custom- developed to serve a single program, and they neither share data nor adapt to new processes easily. The next generation of systems will be faster to deploy, more interconnected and easier to update. Here's why.

MODERNIZATION IS MORE FLEXIBLE

Since 2011, CMS has provided enhanced funding to states for building and maintaining Medicaid eligibility and enrollment systems. The agency will pay 90 percent of states' costs for designing and developing new systems (commonly known as 90/10 funding) as well as 75 percent of the ongoing maintenance and operation expenses. The federal government also relaxed its cost allocation rules contained in OMB Circular A-87 to promote integration between health and human services systems. Previously, the OMB required specific cost allocations for state programs that shared IT systems, which aligned with the proportion of their use of these systems. The current A-87 waiver lets states bypass the normal cost allocation methodologies. Instead, they can charge the initial build to Medicaid--paid for with 90/10 funding--and pay for the additional cost under the A-87 exception that's required to make the system reusable for other programs.

Together, these changes give states an opportunity to not only modernize aging HHS systems, but build them in a more Integrated way. The opportunity may not last forever, though. While CMS has extended 90/10 funding indefinitely, the A-87 cost allocation exception only will be in place until 2018, meaning states that want to reap significant cost savings from implementing shared IT systems have less than two years to do so.

What You're Doing:

Integrating HHS Programs and Systems

Washington State used a portion of its $65 million grant from the CMS State Innovation Model Initiative --which has awarded nearly $300 million to 25 states to design or test innovative models of service delivery and health care payment--to integrate physical and behavioral health services for its Medicaid population. This particular change effort is significant, impacting how services are administered, financed and delivered for Medicaid beneficiaries, according to Dorothy Frost Teeter, director of Washington's Health Care Authority. It also requires deep engagement with members of the community who haven't always been at the table for health transformation efforts. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.