New Mexico’s Medicaid System Replacement Is Now Considered “High-Risk”

Published: May 17, 2019

Government PerformanceHealth CareHealth ITHealth ServicesInformation TechnologyMedicaid Management Information SystemsNEW MEXICOSocial Services

The $201 million upgrade to the state’s Medicaid information system has been deemed a high-risk project due to repeated delays and other problems.

According to a report delivered earlier this month to New Mexico’s Legislative Finance Committee, the state is engaged in a “high-risk” computer upgrade aimed at improving the delivery of Medicaid services. Since 2014, the state has been in the process of replacing its 20-year-old Medicaid Management Information System (MMIS) with a MMIS Replacement (MMISR) Solution. However, this $201 million project has been plagued by a host of problems since it began nearly six years ago. The state has repeatedly missed target deadlines for awarding contracts, as well as encountering serious staffing problems.

The MMISR Solution is supposed to comprise multiple modules and business services using contracts that encompass both technology-based components and business process optimization. Replacing the current MMIS is not only a federal requirement, but is also part of a broader initiative by the state’s Human Services Department (HSD) to improve programs throughout the agency. Despite the initiative’s title of “Health and Human Services 2020,” the Medicaid system replacement project has been pushed back two years, to the end of 2021. 

Described as the “the largest and most complex project in [New Mexico’s] government” by human services secretary David Scrase, the MMISR Solution is a project that still holds a lot of potential for some state officials. In fact, Scrase and his deputy secretary Russell Toal believe this new solution will transform the way the state provides services. They envision people being able to use smartphones to apply for Medicaid or other assistance programs and getting immediate answers on their eligibility.

Moving forward, the report suggests that the state improve its oversight of the private vendors hired to implement the new modular system, as well taking other steps to keep the project on track. According to the report, repeated staff turnover has been an issue not only for HSD, but for its vendors as well.

“The report is concerning, without doubt,” said Senator Carlos Cisneros (D-Quinta), who is not alone in his concern. Many of his fellow state legislators are also worried about the project’s progress, particularly because of how much money has already been spent on it.   

With about 40% of New Mexico’s population receiving services through Medicaid, implementing the MMISR Solution is an incredibly important project for the state. However, Scrase has assured lawmakers that he and other top officials are moving to address the problems highlighted in the report. By reassigning some vendor duties and restructuring contracts, Scrase and his team are optimistic they can complete the project successfully.

Source: Albuquerque Journal