Medicaid claims processing
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CMS Supports Open Source/Modular Medicaid Information Technology
Investing in the future of Medicaid is one of the single biggest opportunities in the health care sector...Overall, CMS’ annual investment in state Medicaid Information Technology (IT) is more than $5 billion, enabling states to modernize their Medicaid IT systems to best meet their program, providers’ and beneficiaries’ needs. CMS and states are prepared to invest in innovative solutions. For this investment, we expect significant advances. Our new regulations require that states evolve their legacy Medicaid IT systems to leverage reusable solutions, and to practice industry-proven IT methods such as use of modularity, reuse, shared services (including Software-as-a-Service) by fundamentally shifting the financial incentives away from custom development. This opens opportunity to smaller vendors to develop focused solutions for use across multiple states or to introduce solutions from comparable sectors such as commercial insurance or large provider systems.
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Pitching Medicaid IT in Silicon Valley
Earlier this year, I announced a new effort to connect new, innovative companies and their investors to the state Medicaid program IT space. Since this announcement, I have been encouraged by the initial interest from companies that may not have otherwise ever thought about participating in this important health insurance program that covers more than 72 million Americans. That’s why I’m in Silicon Valley today to participate in a forum on bringing technological advances to Medicaid. The forum is convening states, innovative tech companies, and federal Medicaid officials on how to collaborate to improve the delivery of Medicaid health coverage in states.
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