Why you should involve providers in software implementation
The U.S. Centers for Medicare & Medicaid Services (CMS) continues to encourage health and human services agencies to implement modular and interoperable software for care management, data management, incident management, etc. Put another way, any technology that is used to manage Medicaid programs should play nice with others.
Recognizing these projects are costly for agencies with limited budgets, CMS offers financial incentive – mainly an increased federal match – for the implementation and operation of systems that meet specific modularity and connectivity requirements.
But increased connectivity across the continuum of care is just one of the benefits offered by a new software implementation for the health and humans services agencies acting on these recommendations. There is also an opportunity to reevaluate system needs, determine how processes can be more efficient and involve key stakeholders in the design and development of the solutions they will also be tasked with using.
Studies have shown that the administrative hurdles involved in Medicaid program enrollment and claims processing are enough to discourage willing and qualified providers from taking on Medicaid patients. This is why they need a seat at the table.
Providers have direct knowledge of the day in and day out challenges in enrolling in Medicaid programs, serving vulnerable populations and submitting claims for payment. Involving providers early and often in software implementations can help health and human services agencies find ways to bring care and services to people more efficiently.
