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Replacement Medicaid Computer System on Track, Outside Consultant Tells DHHS

 

Pat McCrory, Governor
Aldona Z. Wos, M.D.,Secretary

North Carolina Department of Health and Human Services
For Immediate Release
February 21, 2013
Contact: Julie Henry 919-855-4840
julie.henry@dhhs.nc.gov

Raleigh, N.C. – Today, the North Carolina Department of Health and Human Services (DHHS) released the report of an independent assessment* by Susan D. Young, a Charlotte-based IT consultant brought in to gauge the readiness of the replacement Medicaid computer system (MMIS) in the lead up to the July 1 transition date.

The assessment was conducted between January 7, 2013 and February 1, 2013 at the request of DHHS Secretary Aldona Wos, M.D. and shows that the new MMIS system is on schedule to transition, but there are still critical risks that must be mitigated.

“The biggest risks I found were centered around communication, customer service and business strategy,” said Susan Young. “This is a large and complex system, with a lot of players involved, so making sure providers and key stakeholders across the entire organization know how to use the new system properly will be key to making the transition successful."

The new Medicaid Management Information System (MMIS) will replace a 35-year-old computer system that processes 88 million N.C. Medicaid claims each year on behalf of 1.5 million Medicaid recipients, issuing checks to 70,000 providers totaling more than $11 billion.

Young identified two other key risks for replacement MMIS to go live July 1 “within reasonable budget, time and quality parameters:”

  • a testing schedule made tighter by critical system changes, such as restructuring of Medicaid personal care services and conversion of Local Management Entities to Managed Care Organizations;
  • ensuring all business processes are accounted for, including those that will not be incorporated into MMIS immediately, and will require a temporary workaround procedure.

Joseph Cooper Jr., the new Chief Information Officer for DHHS, said the Department is using Young's assessment to take proactive steps to mitigate top-level risks and the systems-level flaws identified in early testing.

“To ensure a smooth transition to the new system, we are working diligently to identify risks and system flaws sooner rather than later,” said Cooper, who has 35 years of technology executive experience in the private sector. “The department is actively pursuing ways to communicate effectively with our partners to ensure there is little to no interruption in services or payments.”

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