Medicaid Modernization

The Challenge

Medicaid agencies are facing dynamic changes in Medicaid policy and implementing Medicaid Information Technology Architecture (MITA) goals. Addressing these challenges, agencies are embarking on the daunting task of modernizing their Medicaid Management Information Systems (MMIS).

An MMIS modernization project offers opportunities for breakthrough advances in services, efficiencies and controls. It also presents major risks to your agency and those who depend on you.

The challenge is great. Defining the requirements, mobilizing stakeholders, transforming business processes, organizing project teams, evaluating implementation vendors, designing, developing, testing, training, deploying and supporting the system – the effort is huge, visible and exceedingly difficult.

Your budgets are tight. Your staffs are busy. Your experience in complex IT projects is limited. Where can you turn for the experience and expertise you need to help make your modernization project a success?

The Solution

CSG provides your MMIS modernization effort with an experienced partner totally dedicated to your success.

We assist you with Strategic MITA Planning for your State Medicaid enterprise, MMIS Procurement Support, Project Delivery Oversight, Independent Verification and Validation (IV&V) and overall Project Management.

Independent of implementation vendors, we focus exclusively on your specific operational environment and solution requirements.

Our people bring years of experience in Medicaid operations, MMIS and MITA, as well as IT architectures, methodologies and project management. Our reputation for close collaboration, exceptional quality and total dedication to your success means you have a partner you can count on to help overcome your most difficult challenges.

When facing the long, difficult journey of MMIS modernization, count on CSG to be with you every step of the way.

Supporting Ohio's Medicaid Enterprise

Ohio’s Medicaid program is the sixth largest health care purchaser in the country, providing health care coverage for 1.8 million Ohioans at an annual cost of nearly $12.5 billion.

The State’s Medicaid enterprise depends on its Medicaid Management Information System (MMIS) in managing this critical responsibility.

The Ohio Department of Job and Family Services (ODJFS) is undertaking a large and highly visible effort to modernize its MMIS to support dynamic Medicaid policies and address MITA goals today and in the future.

Ohio’s MMIS Modernization effort presents daunting challenges. The people of Ohio are making a huge investment in the effort. The technology is complex. The business rules are complex. But the opportunities are great.

CSG and IV&V

One of the ODJFS strategies for overseeing the project is the adoption of an Independent Verification and Validation (IV&V) program. CSG is their partner in fulfilling this critical management function.

CSG serves as ODJFS’ “eyes and ears” into the inner workings of the MMIS Modernization project. Independent of the implementation vendor and the project team, we provide insight into all aspects of the project: requirements management, adherence to the schedule and budget, project governance, technical architectures and organizational changes. Using proven project and quality assurance processes and independent testing methods, we identify major risks and develop effective mitigation strategies.

Together, ODJFS and CSG are working to ensure that the MMIS Modernization effort meets the needs of Ohio’s Medicaid enterprise and the people who depend on it.