The push away from old mainframe IT system to a more flexible, integrated type of model is one of the goals the CMS established through its Medicaid Information Technology Architecture initiative, which the agency defined as a “national framework to support improved systems development and healthcare management for the Medicaid enterprise.” The federal government has offered to fund 90% of the cost for states to develop or enhance their MMIS by December 2015. According to the CMS, the agency has received 453 MMIS requests from all 50 states and the District of Columbia for funding for projects to make changes to existing systems at a total cost of about $3.9 billion.
In spite of the opportunity for states to upgrade their systems, only 20 of the 26 states surveyed in June by the National Association of State Chief Information Officers say they expected to have their health IT systems modernized by next year.
Federal guidelines require every state to operate their own technology to support the administrative functions—such as claims processing from providers and eligibility verification of Medicaid enrollees. It means the use of large stand-alone mainframe computers that usually take years and millions of dollars to upgrade or replace.
Illinois had been looking for a way to upgrade its system for 10 years, DePooter says. But his agency could not find a viable way of moving forward that wouldn't cost the cash-strapped state millions for a new system. The solution for Illinois came in 2011 when Michigan received certification from the CMS for implementation of its new Community Health Automated Medicaid Processing System (CHAMPS), a cloud-based service developed and operated by CNSI, an IT firm based in Maryland. Over the course of 18 months, the two states worked on integrating the two Medicaid IT systems to service the distinctive needs of each state's Medicaid program.
“Michigan was pretty cutting edge in terms of looking toward cloud technology and shared services from a regional and state perspective,” DePooter says. “It was looking toward sharing some cloud-based shared services with other states, so we started talking about whether we could do something like that for the MMIS system.”
The first phase of the Illinois-Michigan shared MMIS project is scheduled to launch in March 2014, according to Lyon, with the system expected to be fully up and running by the end of 2015.
CMS spokeswoman Emma Sandoe says the two states' shared MMIS model is consistent with the agency's standards and regulations. The CMS has pushed for more similar types of collaborations where states utilize modern technology to address their program demands. “It's definitely encouraging that states are working together to find answers that best suit the needs of both of their populations,” she said.
Cost savings aside, for Illinois, the partnership reduces the amount of time and staffing the state has to devote to implementing a new system. Since the CMS has already certified Michigan's system, Illinois will not have to go through the federal certification process, which normally takes up to nine months. Another benefit of the partnership for Illinois is that the state can use the transition process Michigan went through to update its system as a guide as it phases out its own MMIS over the coming months, reducing the risk for potential problems with implementation.