CMS deciding to Contribute $5 billion to modernize Medicaid IS

The Centers for Medicare and Medicaid Services (CMS) is making preparations to pay $5 billion to modernize the IT that support the Medicaid management data systems of most states.

CMS, which invests 90% of MMIS systems now in use, is funding development of latest systems to replace present legacy systems that are generally decades old and have historically been very costly to function. Additionally, existing systems do not properly support accountable care and population health management, claims Steve Larson, executive vice president at Optum Government Solutions, the lead vendor.

The expertise of Optum deploys in pharmacy benefits management, project management and data analytics for quality metrics and population health among other facilities.

Joining Optum is payer software vendor Medecision and TriZetto, which gives analytics for utilization consideration and care management along with a health data exchange. TriZetto actuallu has sizable business in the Medicaid area, processing four million yearly transactions in eighteen states. Facilities that Medecision offers involve integration and execution expertise.

The industries will utilize a range of advanced modular software to update the functions of existing MMIS networks, and however the industries will be capable to give completely new MMIS systems, most of the modernization will include the execution of modules, Larsen claims.

The team of vendor also can run the MMIS on behalf of a state, he further adds.

In the first 2 or 3 years, the market for updates could hit the $2 billion range, with the team choosing up more business in the subsequent years, Larsen claims.