Managed Healthcare Executive poses this question with regard to the establishment of state exchanges: Will each state build their new statewide health IT infrastructure from scratch? Fortunately not.
The idea that states will be able to share some core exchange components is driving $241 million in HHS “early innovator” grants awarded in February to Kansas, Maryland, New York, Oklahoma, Oregon, Wisconsin, and a multi-state consortium led by the University of Massachusetts Medical School.
In Kansas, the grant will fund a solution that lives “on the cloud,” which other states can use. New York will build from its Medicaid management information system (MMIS), which already processes payments for about one of every three healthcare dollars paid in the state.
“What’s interesting is that there are no two states that are thinking about it the same way,” [Brian] Russon [of Microsoft] says. “But from a core exchange component, we’ll see heavy similarity in the consumer portals and the ability for the exchange engine to plug into what we’re hoping to see: very data hub-centric approaches, especially as states look at connecting into federal systems.”
Andrew Naugle, a principal with the consulting firm Milliman, notes the challenges associated with the many different MMISs in use.
“Hopefully, the federal government will come up with a standardized way to access its systems,” Naugle says, “but on the state side, there could be many different ways to interface with the various state Medicaid systems. So there will be a lot of customization even if a state pursues a commercial product off the shelf.”
Whether states build their exchange technology from existing systems or start with a commercial exchange solution, linkages to other state and federal data systems, which currently are silos of information, need to be built. The biggest challenge right now is the infrastructure, says Naugle.