Contact Solutions Blog

MMIS Changes Will Require Experienced Contact Automation Support

The Medicaid Management Information System (MMIS) conference in Portland last week addressed what are going to be the most significant changes since the inception of Medicaid. With these changes, America is redefining its core healthcare business in order to provide higher quality of life for its citizens.

Let’s look at some of the changes:

Customers – An additional 32 million customers (people receiving healthcare benefits) will be added by 2019. The new customers are expected to have higher incomes and higher education levels. It was stated at the conference that the goal is now to deliver best-in-class services such as those offered by Amazon or LL Bean.

Channels – Providing healthcare will expand to include Medicaid and CHIP, Exchanges (new), Employer provided and Medicare. Customers are expected to move between these channels during their life.

Costs – Significant changes in the cost structure of providing healthcare is expected as the focus shifts toward prevention.

Capabilities- A new focus for government healthcare is being a partner instead of being a safety net. This new focus requires new capabilities in systems, processes and rewards. New capabilities are being built in IT systems to deliver the healthcare including business architectures defined by the MITA framework. New systems are designed to be open, modular and support change.

Competitors – We can define a competitor in this case as the status quo or the uninsured.

With change can come significant risk. We would posit that what state’s need to look for while they are reshaping their offerings – online and by phone – is a private sector partner that that has experience in creating automated contact solutions for both government and private healthcare.

Why? First, there is the risk, as there is in all major initiatives, for the “lemming affect,” in which lots of companies with no prior experience form to create solutions. The problems that could arise from that type of partner would take hours to outline. Finding a partner with a good track record of not only creating robust IVR solutions but also monitoring and tracking progress and growth and actually adjusting the solution as it grows is what a state really needs.

The people who are leading this transformation are dedicated and passionate about achieving their goals, but they will need to hire and implement communications systems that have a deep knowledge base and track record to keep abreast of changes while improving the communication process between the customers and the state Medicaid/CHIP programs. Securing a contact automation solutions provider that offers solutions adaptable to rapid change and dynamic and flexible enough to respond to ongoing fluctuations in service levels is what the states need to support MMIS changes.

Will your state be prepared to support MMIS changes?

Tags: Contact Automation, Contact Centers, Continuous Improvement, customer satisfaction, healthcare, improved automation, Obama