A lot has changed in the Medicaid program since 1965. In the last few years alone, several legislative initiatives have changed the direction and policies of the Medicaid community, including (but not limited to): the American Recovery and Reinvestment Act (ARRA), the Children’s Health Insurance Program Reauthorization Act (CHIPRA), the Health Information Technology for Economic and Clinical Health Act (HITECH), the Patient Protection and Affordable Care Act (PPACA), the Health Insurance Portability and Accountability Act (HIPAA), and the International Classification of Diseases (ICD-10). Besides changing policies, most states are burdened by legacy Medicaid management information systems (MMIS), struggling to keep up with recent mandates to integrate with health insurance exchanges (HIX) and health information exchanges (HIE).
Luckily for states and vendors, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited draft of the Medicaid Information Technology Architecture (MITA) 3.0 document in early November 2011. The MITA initiative was first introduced back in March 2006 with the goal of establishing national guidelines for processes and technologies to improve state administration of Medicaid programs. MITA had several objectives in mind, including:
- Develop integrated systems with seamless communication to achieve Medicaid goals through interoperability and common standards.
- Promote flexibility, adaptability, and shorten response time to program and technology changes.
- Promote an enterprise view that supports technologies aligned with Medicaid business processes and technologies.
- Provide data that is accurate, timely, and easily accessible to support business analysis and decision-making for program administration and effective health care management.
- Coordination with public health partners.
- Provide performance measurement for accountability and planning.
These goals should not be new to those in the health care industry. Boiled down, the ideals can be found in several of the newer policies mandated by the federal government. CMS is looking for states to adopt data and industry standards for the promotion of reusable components and modularity. MITA aims to provide a beneficiary-centric focus, supported by interoperable and open architecture. Secure data exchange is vital for the integration of clinical and administrative data, especially with the interchange between Medicaid systems, HIXs, HIEs, and integrated eligibility systems. Parallel to the human services community, MITA also looks to break down those often-discussed “artificial boundaries” between systems, geography, and funding.
Deltek has tracked several state procurements surrounding the MITA initiative, specifically MITA SS-A. With the passage of the HITECH Act, several states incorporated MITA planning into their Medicaid health information technology (HIT) plan. Vendors need to embrace MITA and every future version that follows as roadmaps are updated to adopt new and improved guidelines. Software solution vendors in the health care and human services space will need to incorporate MITA standards and ideals into their products if they intend to win government business now and in the future.
Deltek subscribers should look here for an upcoming analyst perspective diving deeper into the MITA 3.0 topic.