The 2019 Medicaid Enterprise Systems Conference (MESC) ended last Thursday, August 22, 2019. The MESC conference is an annual meeting for State, Federal, and private sector individuals to exchange ideas related to systems and health policy affected by those systems. I left there with my mind stimulated by a bunch of new ideas, my heart full from seeing so many friends and colleagues from across the country, and my feet tired and achy (let’s be honest – the McCormick Place Convention Center was HUGE). I’m still processing everything I learned, so here are five key takeaways:

#1: CMS is Invested in the Success of States

It turns out that in order for CMS to do a good job with their part of the Medicaid IT funding process, they must work together with states. The transition to a single State Officer is an attempt to streamline the process for states to interact with CMS. Instead of a state trying to figure out how to navigate the complexities of different funding streams, they should be developing a partnership with their State Officer, who focuses on educating CMS on what the State Medicaid Agency is trying to accomplish. I heard Ed Dolly say it best on Monday afternoon at the workshop, “You Be the State Officer,” when he said, “CMS cares about State Medicaid Programs achieving their desired outcomes and we have to work together to make that happen.”

#2: Reducing Procurement Pain is the Name of the Game

Whether it is working with 18F or folks from the US Digital Service, many states are progressing through a process of using micro-procurements to advance their mission critical projects. By breaking things down into smaller chunks, states lower their overall risk to delivery (and increase their dependency on procurement people to perpetually work on procurement activities in support of projects). Other states have entered into partnerships to purchase collectively through the National Association of State Procurement Officers (NASPO) ValuePoint. These states are aggregating their buying power for things like claims processing and third-party liability services. Both states and vendors are very interested in how these experiments will impact outcomes for their states. And I’m advocating for a procurement-specific track next year – helping states be better buyers, and helping new vendors figure out the rules of the game to sell to states.

#3: Early Results for Outcome-based Certification Pilots is Promising

This year, CMS launched its first outcome-based certification (OBC) pilot for Electronic Visit Verification (EVV) modules. Every state must have their EVV solution certified by 1/1/2020 or face a federal fund penalty in their Medicaid program. Given the state of affairs with EVV implementations, this meant many, many states were going to have to get their solutions certified within a very short window, thereby requiring a massive staffing effort on both sides. CMS and their partner MITRE, which operates the Health Federally Funded Research and Development Center (FFRDC), designed an OBC process for EVV that took the state hours to produce documentation for, rather than weeks or months. The results have been so promising that Julie Boughn shared a desired Key Result of the next 12 months: 100% of EVV certifications happen using the new OBC process. And the team from Puerto Rico told me they are conducting an OBC pilot for their new MMIS in the coming weeks. I’ll be interested to watch the overall effort it takes for both sides to complete their work.

#4: Giving Back Feels Amazing

This year, I had the pleasure of working with a local Chicago non-profit, Girls, Inc as part of a special learning day designed to expose high school girls to Medicaid and Technology. Our friends at CSG Government Solutions hosted 16 young women in their Chicago headquarters. The interactive workshops had girls doing user-centered design sessions on a sample Medicaid eligibility application and preparing a debate on the pros and cons of implementing work requirements as a condition of Medicaid participation. But perhaps the shining moment was watching these girls take the main stage and share what they learned with the audience. As a certified B-corporation, Audacious Inquiry is always looking for ways to give back and my involvement in this day was such a blessing as I got so much hope from seeing the next generation. If you have a daughter or granddaughter, I encourage you to learn more about the chapters of Girls, Inc nationwide and find a way to contribute: https://girlsinc.org/find-girls-inc/

As a certified B-corportation, Ai is always looking for ways to give back. I encourage you to learn more about the chapters of Girls, Inc nationwide and find a way to contribute. Click To Tweet

#5: It’s Not Too Late to Keep Learning

The best part is you can have access to all the slides of presentations that occurred over this week. The MESC team has made them available on Google Drive which means you can take advantage of the learnings from all the sessions that you could not make it to. Additionally, the folks at NESCO want to continue the conversations and learning in between MESC conferences. As such, they have created a LinkedIn Group, so make sure you join it and share information or start conversations with Medicaid IT Professionals and vendor partners across the country.

What did you take away from #MESC2019? Julie’s parting challenge to the group was: “What will you do in the next 30 days to contribute to our shared key results?” This blog post is my first action – sharing what I learned from others. I am refreshed after the weekend of rest and hoping to continue to ride the wave of hope that comes from being with 1700+ people who know #MedicaidMatters. What will you do in the next 30 days?


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Sarah Miller
VP of State Government & HIE Account Management | Audacious Inquiry

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