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Deltek Pulse: Health and human services month in review, April 2015

In April 2015, Deltek saw a slight decrease in the number of health care and social services solicitations compared to March

Notable RFP releases

In legislative news, the Centers for Medicare and Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) on April 14 to permanently extend 90/10 funding and update the Medicaid Management Information System (MMIS) Standards and Conditions, including a new modular certification process for MMIS components. For an analysis of how this proposed regulation will impact vendors, please click here to access the GovWin IQ blog.

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.


90/10 funding made permanent: CMS updating Medicaid procurement standards

In October 2014, the Centers for Medicare & Medicaid Services (CMS) announced that 90/10 enhanced federal funding would be permanently available for states making upgrades to their Medicaid eligibility and enrollment systems. This funding encourages states to retire defunct Medicaid systems, modify existing eligibility and enrollment (E&E) systems, and integrate Medicaid systems with other human services systems.

On April 14, 2015, CMS issued a notice of proposed rulemaking (NPRM) to codify the 90/10 permanent extension and proposed changes to the Medicaid Management Information System (MMIS) standards and conditions, including a new modular certification process for MMIS. The agency is also soliciting feedback on how to encourage the sharing of Medicaid software and reduce duplicative costs. Public comments are due June 15, 2015.

Key takeaways

1) CMS getting more involved in Medicaid procurement process - CMS is proposing a new contract review process and will help states develop acquisition roadmaps for future procurement. States will look for solutions that already comply with the Seven Standards and Conditions issued by CMS.

2) CMS proposing modular approach to certification - CMS recognizes that most monolithic contracts go over budget and over schedule when states get locked into one vendor, such as those in Maryland, Montana, Nebraska and North Carolina. The agency is offering to certify MMIS systems on a modular basis. We can see many states are already following this approach, such as Texas, Louisiana, Mississippi, and South Carolina.

3) Preference for shared software and COTS solutions - CMS is trying to encourage states to adopt commercial-off-the-shelf (COTS) solutions to save money and reduce duplicative implementation efforts. The NPRM proposes a 90 percent matching rate for COTS software, and vendors including HP, Molina, EngagePoint and Accenture are increasingly offering COTS solutions that are flexible and adaptable for states. 

Analyst’s Take

While making 90/10 funding permanent, CMS is also using this opportunity to update certification procedures to keep pace with the MMIS modular procurement strategy most states are adopting. In 2015, Deltek is expecting MMIS rebids in Florida, Louisiana, Mississippi, Missouri, South Carolina, Texas and Virginia. Vendors will have a leg up on the competition if their solutions are in line with CMS standards for COTS products and align with the desire to use modular components and incremental delivery strategies. The benefits are greater with these approaches by reducing risks and lowering costs of complete replacements. Still, as strategy moves away from single fiscal agent contracts and big-bang implementations, states have challenges managing multi-procurements and relationships with several vendors. For more information on Medicaid procurements across the country, please see the GovWin MMIS Vertical Page.


Deltek Pulse: Health and human services month in review, March 2015

In March, Deltek saw the release of 1,831 solicitations from the health and human services vertical – a 31 percent increase from February.

Notable RFP releases

  • The Alabama Department of Human Resources released a request for proposals (RFP) for electronic benefits and funds transfer (EBT/EFT) services on March 5. The incumbent contract with Xerox is set to expire in June 2017. Proposals are due on June 25, 2015.
  • The Pennsylvania Department of Health released an RFP for WIC EBT implementation and claims processing services on March 13. Proposals are due on June 11.
  • The National Association of State Workforce Agencies (NASWA), with its subsidiary Information Technology Support Center (ITSC), released an RFP for independent verification and validation (IV&V) services for the Mississippi, Rhode Island and Maine (MRM) Consortium for the joint UI modernization project on March 23. TCS was selected as the prime developer for the modernization project and is currently refactoring MDES UI system’s architecture to accommodate the implementation of a largely common set of functionalities among the MRM states. Proposals are due on May 1.
  • On March 25, the Virginia Department of Treasury released an RFP for electronic payment card services. Current users of electronic payment services include the Department of Accounts (DOA) for payroll, the Department of Social Services (DSS) for child support and TANF benefits, the Virginia Employment Commission (VEC) for unemployment benefits, and the Department of Taxation (TAX). Proposals are due on April 27.

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. 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 and human services month in review, February 2015

In February 2015, Deltek saw the release of nearly 1,400 solicitations from the health and human services vertical, on par with the 1,340 solicitations released in January.

Notable RFP releases:

  • The Maryland Department of Labor, Licensing & Regulation (DLLR) released an RFP for the Vermont, Maryland and West Virginia (VMW) consortium's unemployment insurance (UI) information technology modernization projectThe new system will consist of core UI benefit, tax, and appeals software common to all VMW states, while allowing each state to continue to address their own specific goals. Proposals are due by March 26. 
  • The Louisiana Division of Administration Office of Technology Services issued an RFP for the Medicaid enrollment and eligibility system. The Department of Health and Hospitals (DHH) is seeking to implement an automated solution that will support Medicaid eligibility and enrollment processes using modern and lasting technologies. Proposals are due by April 3.
  • The Oregon Health Authority (OHA) released an RFP for HIE/HIT technology consultancy services to support OHA’s efforts to plan, define, develop, implement, and operate a state-level health information technology/health information exchange (HIT/HIE) infrastructure. Proposals are due by March 16.
  • The Alaska Department of Health and Social Services released an RFP for Medicaid redesign and expansion technical assistance services. DHSS is interested in developing a larger strategy for meaningful Medicaid reform that will improve care and health outcomes for eligible Alaskans, streamline requirements of providers, and create a financially sustainable service delivery system.

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.


Spotlight cast on child care in wake of block grant reauthorization

Congress brought new life to the federal child care subsidy program when it reauthorized the Child Care and Development Block Grant (CCDBG) late last year. States rely on CCDBG funding to help low-income families afford child care and improve statewide child care operations. On top of this long-awaited reauthorization, President Obama highlighted child care in his 2015 State of the Union address, calling for an increased child care tax credit and investments in the Child Care and Development Fund.

The CCDBG reauthorization has refocused national attention on child care and will prompt states to review their child care programs and invest in new technologies as well as quality improvement strategies to meet new requirements. This storm of activity will surely create new business opportunities for IT vendors.

Where will states invest?

1) Quality improvement - The CCDBG reauthorization calls for an increased investment in quality improvement and adherence to new health and safety requirements. States will be looking for vendors to provide child care licensing and other credentialing services, quality rating and improvement systems (QRIS), as well as provider training and education services. In 2014, Colorado awarded a contract to Berry, Dunn, McNeil and Parker for a next generation quality rating improvement system (Opp ID 79106) to improve the quality rating system and expand the availability and affordability of the QRIS. Other states may also seek to improve their systems in the coming year.

2) Improve core processes - States may seek more integrated technologies to improve intake, payment processing, case management, and time and attendance tracking in order to achieve operational efficiencies. For example, Virginia released an RFI in August 2014 for child care business application solutions, including an attendance tracking system that could interface with existing systems and banking networks, and create a provider Web portal (Opp ID 117252). Expect states to issue similar RFIs exploring how to best improve their child care administration processes.  

3) Coordination with other social services programs - The law requires child care providers to coordinate with early education and care programs. States may pursue efforts to exchange data and share information with programs like TANF, Head Start, and SNAP in order to aggregate data and improve child health and wellness programs. One such effort is being planned in Iowa, where the Early Childhood Office is pursuing an early childhood data system to house information about the operation, participation and outcomes of Iowa’s early childhood system, which includes early learning, family support, health/nutrition/mental health and early intervention for children with special needs (Opp ID 89854).

4) Increased consumer education and assistance - States will be required to provide electronic child care resources where parents can view provider inspection results, the number of injuries/deaths at each facility, licensing and monitoring requirements, and detailed information about the background check process. States may look for child care resource and referral systems to help match resources with individual family needs. In July 2014, Arizona awarded a contract for child care resource and referral services to the Association for Supportive Child Care (Opp ID 118194). 

Analyst’s Take

Quality improvement, business processes, integration and consumer assistance are just some of the areas states will target for investment over the next few years. State applications and plans are due to the U.S. Department of Health and Human Services in June 2015. States may solicit vendors to assist with the planning process and conduct needs assessments. States are not expected to comply with new regulations until FY 2016, but vendors can get a head start in preparing how to market their solutions to states. Vendors who can demonstrate solutions that seamlessly integrate with existing technologies and improve program efficiencies will be attractive to state governments.


Deltek Pulse: Health and human services month in review, January 2015

Deltek saw the release of 1,340 solicitations from the health care and human services vertical in January – a 13 percent increase from December.

Notable RFP releases in January include:

  • The commonwealth of Kentucky Cabinet for Health and Family Services (CHFS), Department for Medicaid Services (DMS), has a requirement for a vendor to provide a configurable Software-as-a-Service (SaaS) solution for the Kentucky MEMS claims processing and fiscal agent (FA) services, as well as a custom-built encounter processing solution and a decision-support system/data warehouse (DSS/DW) solution. Proposals are due April 6.
  • The Arkansas Department of Human Services released an RFP for information systems support. The incumbent contract with Northrop Grumman expires on June 30, 2015, and the department is seeking maintenance, support and modifications of its various mainframe and client-server computer applications, as well as maintenance, support and development of new Web-based applications. Proposals are due on April 21.
  • The Mississippi Division of Medicaid has a requirement for independent verification and validation Services (IV&V) for the eligibility modernization project to replace current legacy systems – the Medicaid eligibility determination system (MEDS) and Medicaid eligibility determination system expansion (MEDSX) systems. Proposals are due February 27.
  • The Texas HHSC Office of Social Services (OSS) Division would like to procure services to implement HHSC-established business process redesign (BPR) principles and procedures currently operating in a select number of HHSC pilot offices to all remaining offices, statewide. Proposals are due February 23. 

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.


Medicaid eligibility and enrollment systems: Which states still need to modernize?

Modernized and fully integrated Medicaid eligibility systems have proven to be a catalyst for successful enrollment in state and federally facilitated health insurance exchanges. Kentucky, New York, and Washington state have stood out for their top-performing exchanges and high enrollment numbers. All three states rely on integrated Medicaid eligibility systems that facilitate the consumer application process, eligibility determination, and enrollment in Medicaid/CHIP or private health insurance plans.

On the other hand, states with outdated and isolated technologies struggled to enroll new customers, which led to significant Medicaid backlogs, most notably in California, New Jersey, and Tennessee. Now that the feds have finalized 90/10 funding and extended the OMB A-87 cost allocation exception, more states will invest in upgrading their Medicaid eligibility systems and building integrated eligibility systems that incorporate human services programs, including Supplemental Nutrition Assistance Programs (SNAP) and Temporary Assistance for Needy Families (TANF). This analyst perspective will help vendors identify which states have already completed upgrades, which states are currently modernizing, what contracts may be rebid, and where to find potential business opportunities.

Current Landscape

While states have been working to integrate and modernize eligibility systems for more than a decade now, the vast majority of states took steps in recent years to upgrade their Medicaid eligibility systems in preparation for ACA enrollment. In fact, 19 states have issued contracts for upgrades to Medicaid eligibility and enrollment systems since 2012. Some states combined contracts for health insurance exchanges with eligibility upgrades (HIX/IES), including Connecticut, Maryland, Oregon, Rhode Island and Washington, D.C. Other states are still in the early planning stages for eligibility system modernization efforts, and a few states have indicated their intent to release a solicitation in the coming year. Below is a preview of a few of these upcoming opportunities.

Upcoming Solicitations

Louisiana – The Louisiana Department of Health and Hospitals anticipates releasing a Medicaid Eligibility Determination System (MEDS) request for proposals (RFP) this month. The department is designing new enterprise architecture to modernize the state’s Medicaid technologies. The previous contract with Deloitte was worth approximately $29 million (Opportunity ID 99187).

Massachusetts – The Massachusetts Executive Office of Health and Human Services plans to move forward with Phase II of the state health insurance exchange and integrated eligibility system (HIX/IES). The state expects to complete planning by the end of June 2015, and an RFP could be released sometime this fall, at the earliest. A $66 million contract with CGI was terminated in March 2014, and Optum and hCentive have worked to rebuild the system (Opportunity ID 89076).

New York – The New York Office of General Services is seeking a systems integrator for its integrated eligibility system to replace the statewide welfare management system (WMS) – a legacy system first implemented in 1977. An RFP was issued in May 2014 for a business advisory services contractor that will work during the first phase of the IES project; the systems integrator will conduct phase two. Deltek anticipates this legacy system modernization could approach $100 million (Opportunity ID 49905).

Possible Rebids

Tennessee – The Tennessee Department of Finance and Administration may have a requirement for the development and/or maintenance of the TennCare Eligibility Determination System (TEDS). The current contract with Northrop Grumman is behind schedule and the system remains unfinished, which has created months-long delays for Tennesseans who want to apply for Medicaid. Subsequently, three advocacy groups have filed a lawsuit against TennCare. The incumbent contract is valued at $35.7 million (Opportunity ID 117922).

New Jersey – The $83.5 million contract with Hewlett-Packard for maintenance of the Consolidated Assistance Support System (CASS) has been terminated, and a spokeswoman for the New Jersey Department of Human Services said the state and the vendor are still in talks regarding the contract termination (Opportunity ID 105816).

Early Planning Stages

California – The 2014-2015 Governor's Budget Highlights for the Department of Health Care Services requested expenditure authority for a multi-year IT project to modernize the Medi-Cal Eligibility Data System (MEDS). In 2012, a contract was awarded to PCG for IT project planning consulting services, including a feasibility study and advanced planning document (APD) for the MEDS Modernization Project. An RFP for the Medi-Cal Program integrity data analytics is currently in development (Opportunity ID 69871).

South Dakota – The state issued an invitation to discuss and demonstrate (IDD) to review and research existing Medical assistance eligibility systems that comply with the Affordable Care Act (ACA) and preferably have existing or planned capability to support other programs such as SNAP, TANF, Child Care, Low Income Energy Assistance (LIEAP), and Child Support. The Department of Social Services is now planning an RFP for an integrated eligibility system (Opportunity ID 83922).

Washington – In 2013, the Washington State Legislature passed Senate Bill 5034, directing a study of the state’s medical and public assistance eligibility systems and infrastructure with the goal of simplifying procedures and reducing state expenditures. PCG was awarded the contract to conduct the Medical and Public Assistance Eligibility Study, which was published in September 2014. The state may continue to make efforts to modernize the medical and public assistance eligibility systems (Opp ID 104365).

Analyst’s Take

Now that 90/10 funding has been made permanent and the A-87 waiver is extended until December 2018, states will continue to make upgrades to eligibility systems, which could yield significant business opportunities for vendors. Deloitte is the dominant vendor in this space, currently holding contracts in more than 15 states. Other vendors holding contracts in multiple states include Accenture, IBM, Northrop Grumman, KPMG, HP, and Maximus. Contract values for eligibility modernization projects vary significantly based on the size of the state and scope of the project. Contracts for Medicaid eligibility modernization average between $20-50 million, while IES projects that include major system overhauls can exceed $100 million.

Many states that have recently integrated health insurance program eligibility systems may now look to incorporate human services programs, starting the next wave of procurement activity. As Deltek continues to track upcoming eligibility projects, we encourage vendors to keep an eye on the above mentioned projects and expect to see more eligibility-related opportunities thanks to this funding extension.


Deltek Pulse: Health and human services month in review, December 2014

In December 2014, Deltek saw the release of 1,181 solicitations from the health and human services vertical – a 5 percent decrease from November.

Notable request for proposals (RFP) releases in December November include:

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.


Updated Federal Health IT Strategic Plan Focuses on Interoperability

The Office of the National Coordinator for Health Information Technology (ONC) within HHS, this week released its new strategic plan detailing efforts to promote interoperability of health records and systems.

The new plan recognizes the strides made in the area of electronic health records adoption by US providers and takes these efforts a step further to facilitate the sharing of health data.  Over 400,000 hospitals and professionals now participate in Medicare and Medicaid EHR incentive programs, generating a strong demand for information sharing.

ONC lays out the following five goals to advance accessibility of health information and make it available when and where it is needed to improve and protect people’s health and well-being:  

  • Expand adoption of Health IT 
  • Advance, secure and interoperable health information  
  • Strengthen health care delivery 
  • Advance the health and well-being of individuals and communities  
  • Advance research scientific knowledge and innovation

Each goal is supported by two to three specific objectives with three and six year expected outcomes, along with strategies for achieving each objective.  Additionally, the goals and objectives of the federal health IT plan will be implemented and supported by 37 federal departments and agencies.   The plan is a coordination of these agencies in order to advance the collection, sharing, and use of electronic health information to improve health care, individual and community health, and research

ONC is also in the process of developing a Nationwide Interoperability Roadmap to drive the goals of the strategic plan.   

The strategic plan promotes health IT adoption and information sharing among the commercial market as well as government entities.  Implementation of the plan will involve establishing standards and frameworks for information exchange.  One way for contractors to influence these standards is to participate on committees, boards, and other organizations to influence their development.  Private and public health organizations may need contractor assistance in adopting and incorporating resulting information exchange architectures, standards, and frameworks. 

Public comments will be accepted on the plan until 5 pm on February 6, 2015. 


Deltek Pulse: Health and human services month in review, November 2014

In November, Deltek saw the release of 1,253 solicitations from the health and human services vertical – a 10 percent decrease from October.

Notable RFP releases in November include:

Notable awards made in November include:

You can learn more about current procurement opportunities in the GovWin IQ State and Local Opportunities database. Not a Deltek subscriber? Click here to learn more about Deltek's GovWin IQ service and gain access to a free trial.


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