2019 State HIT Connect Summit

Millions of dollars each year are lost due to lack of information about liable third-party payers. For Medicaid alone, the cost of improperly paid claims climbed to more than $18 billion in 2016 – an increase of nearly $4 billion in three years. More than half of these improper claims were due to incorrect billing from providers who often don’t have updated coverage information especially when Medicaid recipients have access to other health coverage at the point of service. Join us for this session on how HMS piloted a new solution – along with an Ohio hospital provider and Ohio Medicaid – to improve coordination between Medicaid agencies and providers by allowing them to verify and communicate other primary coverage for Medicaid members prior to billing – even at the point of scheduling, admissions and authorization.   
 

Presenters will introduce leading state and local community engagement projects and how interoperability and patient-centered data design are helping care teams better serve communities with complex social, economic and clinical needs. Federal representatives will provide a national perspective on the LTSS, HCBS space, updates on important standards development work, technical assistance resources and consensus building on quality measures. The session will also highlight the opportunity for vendor engagement in a growing but relatively immature HIT segment with huge potential for social impact.

Human Services projects in state government involve large scale data integration efforts. Legacy technology implementations struggle to keep pace with fast-changing integration needs that are both costly and prolong the time to benefit. State government Medicaid modernization projects have made concerted efforts to improve these challenges via closer adherence to MITA standards and improved modularity.  

To that end, this session will discuss a novel approach to human services technology implementation leveraging the Enterprise Data Hub architecture to more quickly integrate disparate data, decrease implementation timeframes and costs, and shorten time to benefit The approach leverages an Operational Data Store pattern that is trusted to both run the business and perform analytics. Two state government MMIS modernizations programs that are currently implementing this pattern will be discussed.

Arkansas has ambitious goals to improve its Medicaid program, with goals to achieve $835 million in savings through SFY 2021 – mainly through program efficiencies, proper utilization of services, and better outcomes – while providing more coordinated and comprehensive services to those who need them.
Critical to this effort will be effectively coordinating care for a relatively small group of Medicaid beneficiaries who represent a significant percentage of costs due to their complex medical and behavioral health conditions, as well as their need for supportive services. This group encompasses about 35,000 beneficiaries accounting for about $500 million in annual spending.
To assess who needs what services – including how many and how often – the Arkansas Department of Human Services selected Optum to complete functional independent assessments; working closely with the state and providers, Optum completed more than 66,000 functional assessments in nine months-with many more to come. Results of the assessments are used to determine whether individuals are eligible for certain behavioral health Medicaid services; appropriateness of home- or community-based care versus more expensive institutional settings; and to develop care plans to improve this group’s health and quality of life. 
This session examines how Optum and Arkansas completed the assessments in nine months-conducting as many as 700 a day at one point – by tailoring a comprehensive assessment tool; employing health and human services professionals to conduct assessments; customizing the underlying technology platform required to support the tool and collect and report data, and offering provider training, support, and outreach.

Every Medicaid agency is responsible for controlling costs in multiple ways, including Third Party Liability activities. Individuals on Medicaid may also have other health insurance, but that other health insurance- whether employer-sponsored, Medicare, or even casualty insurance must pay primary to the extent of its legal liability. 

This round table discussion welcomes both newcomers and seasoned professionals. Attendees will receive a brief refresher on the “What’s, Why’s, Who’s and When’s” of TPL and then move beyond the basics. Our discussion will focus on the impact to and application of TPL practices within a healthcare environment experiencing seismic changes. We will ponder

•    How is your state approaching TPL within the MES vision? 
•    How has TPL changed in light of managed care shift? What are the TPL rolls and responsibilities of your Medicaid Managed Care plans?
•    What changes/choices are you or do you foresee making for your TPL programs as Value Based Delivery models continue to become more popular in Medicaid? 
•    How is your state applying new technologies within your TPL solutions?

Come ready to participate in informative information sharing and to take new ideas back to your State!

Legacy identity solutions come in two types, dated commercial offerings and or self-built components, spread across multiple locations. Accessing this data requires an enterprise to either continue costly support of an out of date solution or look at a means to resurrect this data for use in a modern setting. Join ForgeRock as we discuss a modern identity platform built for a Microservices architecture capable of any deployment (hybrid, multi, cloud) setting by utilizing API’s for the surfacing and federating of legacy data in a modern identity deployment.

This session will help you to understand how leveraging a modern Identity Platform can help your organization to:  

• Accelerate and risk-mitigate your investments as you undertake this critical paradigm shift
• Comply with regulations and simplify complex data-sharing and consent decisions, as well as secure patient-controlled data-sharing across cloud, mobile, and IoT sources
• Enable microservices to transform your organization to new levels of agility and capability, while providing cost savings
• Simplify the use of embedded identity information in legacy systems with 21st century approaches
• Securely connect people, devices, things and events to enable a 360 degree view

The nation’s federal, state, and local Health and Human Services (H/HS) systems are the cornerstone to building a strong, dynamic, and healthy nation. Many H/HS system leaders are readily adopting new, effective, and responsive services that are outcome-focused, and that identify and address root causes of challenges with the assistance of new services and capabilities built on analytical insights. These leaders are evolving their organization from a traditional model based on regulatory compliance and programmatic outputs, to a model that works seamlessly across sectors and engages families and whole communities in addressing the multi-dimensional socioeconomic issues that its families face. Critical to moving toward this model is a strong foundation of a health and human services organization that views data and data systems as fundamental along with the related workforce capacity comprised of personnel who are skilled in driving decisions based on analytics.

To that end, the American Public Human Services Association (APHSA), Optum, The Lewin Group and Chapin Hall at the University of Chicago sponsored a two-and-a-half day symposium for sixty-one state and local health and human services (H/HS) thought leaders from eighteen states on July 20–22, 2018.

This session will feature state participants of our symposium who will present a range of findings and results they’ve advanced coming out of that event. The topics will explore current practices and operations taking place in the H/HS system as well as approaches and challenges to building analytic capacity and culture within their own agencies.

At this session, you will learn how Tulare County justified, planned, implemented and continues to realize success with their Workflow Management Tool (WMT) 12 months post-implementation.
In 2015 Tulare County Health and Human Services had over 700 workers processing approximately 60,000 tasks per month for approximately 75,000 cases. The case management system was over 10 years old and was built to be a customer record and eligibility determination system. Tulare implemented several workaround tools to assist with the management of the workload including a homegrown “task in task out” task management system.

In 2017 Tulare contracted with InTelegy to plan, implement and integrate the Intelegy WMT – Workflow Management Tool. The three-phased approach consisted of Phase I-Assessment and Plan, Phase II- Design and Build and Phase III- Implementation. Learn how InTelegy and Tulare County worked in partnership to implement the enterprise-wide, mission-critical software that is integrated with their case management system and now provides Tulare County with:

·      Standardized Workflow across the office and county
·      Prioritized and equal work distribution
·      A method to manage funding streams efficiently: WMT provides actual time spent by program allowing real-time studies and accurate allocation of time by funding resource
·      Access to Data that shows real-time supervisor & staff level workflow as well as influences management decision making from trending and tracking of critical operational and customer level touch points