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Deltek Pulse: Health care and social services July review

In July, the Department of Health and Human Services (HHS) released yet another round of funding under the health insurance exchange (HIX) establishment grants. Colorado was awarded a Level 2 grant, while Nevada, New Mexico, Vermont, Virginia and West Virginia all received Level 1 grants.

Here’s a quick breakdown of the recent awards:

·         Colorado - $116,245,677

o    Funds will be used to support outreach/education activities. They will also be used to assist in the development of Colorado’s consumer service center.

·         Nevada - $9,020,798

o    Funds will be used to support information technology security requirements, in addition to development of a virtual assistant to allow the state’s HIX to provide one-on-one consumer support and training.

·         New Mexico - $18,600,000

o    Funds will be used to support comprehensive outreach and marketing activities, training efforts, and standards for establishing the state’s Navigator program.

·         Vermont - $42,687,000

o    Funds will be used to support the design, development and implementation of the marketplace portion of fully integrating Medicaid and CHIP into the state’s newly integrated eligibility environment.

·         Virginia - $1,247,402

o    Funds will be used to perform analyses and reviews necessary to support certification, decertification and recertification of qualified health plans and stand-alone dental plans.

·         West Virginia - $10,165,243

o    Funds will be used to support the development of the state’s in-person assistance personnel and plan management activities.

States operating their own exchanges only have two months to get them up and running for consumers to enroll in plans that will begin in January 2014. HHS has awarded more than $4 billion so far in federal funding to support Affordable Care Act (ACA) requirements. This funding, which is critical to states’ development of HIX systems, will continue through 2014.

On the procurement side of the spectrum, July brought a lot of activity across health and social services departments. Here are a few contracts awarded last month:

Missouri - The Missouri Department of Health and Senior Services awarded its “Spirit System Software Enhancements” project to Custom Data Processing.

Arkansas - The Arkansas Health Connector Division awarded CAI to provide a guide management solution.

Wisconsin - The Wisconsin Department of Children and Families awarded Deloitte for “Child Support Enforcement Document Generation, System Integration Implementation and Training Services.”

And here’s a few projects coming down the pipeline:

Pennsylvania - The Philadelphia Department of Public Health (DPH) released a request for information (RFI) for health interface engine solution services. The state is seeking information on ways to facilitate the exchange of health-related data between several applications within the city.

Tennessee - The Tennessee Department of Finance and Administration confirmed plans to release a solicitation for pharmacy benefit management (PBM) services in June 2014. The current contract is held by CVS Caremark and expires in June 2015.

Nevada - The Nevada Department of Administration, on behalf of the Public Employees’ Benefits Program (PEBP), released an RFI for corporate medical exchange services. The state is seeking information on the scope of the market for the exchange to provide health insurance and related benefits to more than 31,000 people.

South Carolina - The South Carolina Department of Health and Human Services anticipates releasing a draft RFP and RFI for Medicaid management information system (MMIS) provider management services.

Wisconsin - The Wisconsin Department of Children and Families released an RFI for “Temporary Assistance for Needy Families and Collections Mainframe Transition Services.” The department is seeking information regarding moving similar systems from a mainframe environment to the Web.

Florida - The Florida Department of Health released an RFI for patient portal services. The department is looking to integrate a commercial solution to provide functionality required of a patient portal as a component desired to meet the 2014 electronic health record (EHR) certification criteria.

Want more? Be sure to check out Deltek’s robust database of opportunities that extend beyond the health and social services arena. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.  

Deltek Pulse: Health Care and Social Services July Review

Much of July was spent grappling over the immediate and long-term impacts of the passage of the Affordable Care Act (ACA), particularly states’ flexibility to expand Medicaid eligibility. As states begin to conduct analysis on the fiscal impact of expansion, few states are unexpectedly finding Medicaid expansion will keep them in the black, not the red. Two of these states are Arkansas and Oklahoma. Arkansas estimates Medicaid expansion could save the state $372 million from state fiscal year (SFY) 2014-2021, or about $53 million annually, while Oklahoma estimates expansion could save the state nearly $48 million annually.

These estimates contradict state budget directors’ opinions on the fiscal impact of Medicaid expansion. Based on a survey conducted by the Government Accountability Office (GAO), the majority of the 42 state budget officers who responded believe the costly items associated with Medicaid expansion are: administration for managing Medicaid enrollees, acquisition of/or modification to enrollment systems, and enrolling the previously eligible population.

Despite the ongoing discussions and negotiations regarding Medicaid expansion, health insurance exchanges (HIXs) and other ACA-related provisions, states continued to make procurement plans and release solicitations to update or reform their health care delivery systems. A few highlights include:

  • Indiana’s Family and Social Services Administration (FSSA), through the state’s Department of Administration, issued a solicitation for enterprise Medicaid system project management, which covers the core Medicaid management information system (MMIS), data warehouse, and pharmacy benefits management.
  • Nebraska’s Department of Health and Human Services (NDHHS), Division of Medicaid and Long-Term Care (MLTC), issued a request for information (RFI) for provider enrollment management, data solutions, or credentialing services.
  • Washington state released a work request in mid-July for project management team services for the state’s MMIS. The selected project management team will collaborate with the Washington Health Care Authority (HCA) and third-party vendors to configure IT infrastructure and develop an RFP for fiscal/employer agent services.
  • Georgia’s Department of Community Health (DCH) announced that due to uncertainty at the federal level, the state will not move forward with a full-scale transformation of its Medicaid and PeachCare for Kids programs. Instead, DCH and Navigant Consulting have identified smaller-scale changes that will work to improve patient care and streamline internal program administration.
  • Nebraska, which plans to leverage an existing RFP for its health insurance exchange (HIX), will procure for IV&V services in support of the exchange.

In the coming months, states will continue to rapidly issue solicitations for HIX-related services, including project management, systems implementation, and quality assurance (QA), to meet the October 2013 implementation deadline, which is now just more than a year away. Similarly, many states are looking into implementing integrated eligibility systems (IES), particularly with the limited-time availability of 90/10 funding to do so, and will require similar services from the vendor community.

Deltek recently released its newest report, “New Players and Future Prospects in MMIS,” which explores the constantly-evolving development of Medicaid management information systems. For more information and analysis on the new players and future prospects of MMIS, please check out Deltek’s new report.

Follow Deltek's Health Care and Social Services Team on Twitter @GovWin_HHS or connect with us through LinkedIn.