Annual Medicaid Enterprise Systems Conference (MESC) kicks off

Published: September 10, 2013

Government PerformanceHHSHealth CareHealth IT

Yesterday, South Carolina Governor Nikki Haley helped kick off the 2013 MESC Conference, focusing on enabling health care innovation. Both the governor and Tony Keck, director of South Carolina’s Department of Health and Human Services, acknowledged that the state is against health care reform, but stressed that conference sessions aren’t about arguing which side is best. Instead, panels will look at how to provide quality, efficient, and innovative health care services regardless of how a state implements health care reform.
One of the largest sessions of the day revolved around the Centers for Medicare and Medicaid’s outlook on the Medicaid program as it moves through the October 1 go-live date and beyond. Julie Boughn, deputy director for CMS and CHIP services, said 2014 will be history making and that CMS has been focusing heavily on the readiness of both Medicaid and CHIP agencies. Day one (October 1) will be defined by the following critical success factors: 
  • Systems accept new MAGI (modified adjusted gross income) income standards
  • Single, streamlined application processes
  • Electronic data verification
  • Electronic account exchange
  • Hosting the Medicaid/CHIP current enrollment service
  • Providing CMS with necessary data to accurately program the FFM (federally facilitated marketplace) for each state’s eligibility rules and correct contact information
  • Adjudicate eligibility based upon the MAGI rules
CMS expects that “in one way, shape or form,” all states will be ready for the exchange go-live deadline. CMS re-launched, and the federal call center went live in July. Agents are currently fielding calls and conducting live, online chats. CMS has worked through privacy and data agreements with federal agencies that will be exchanging data and recently signed Delaware to connect to the federal hub as part of its computer-matching authority. Day two (October 2) performance indicators will be sent to CMS on a weekly basis and include:
  • Total call volume
  • Call center wait time
  • Abandonment rates
  • Number of applications received in the previous week
  • Number of applications received in the previous month
  • Number of electronic account transfers
  • Number of renewals
  • Total enrollment
  • Total number of individuals determined eligible
  • Total number of individuals determined ineligible
  • Pending applications/redeterminations
  • Processing time for eligibility determination
CMS is currently working on an online data tool for states to enter the above information, and received voluntary states’ data for comparison. CMS stressed that states shouldn’t forget there are still two more years of enhanced federal funding to continue innovating state Medicaid programs and revisit plans to add human services programs into the mix. Stay tuned for more updates from the 2013 MESC Conference as the week continues!