Eligibility for Medicaid is expected to increase by 5 million to 18 million people by the end of 2020, depending on how high the U.S. unemployment rate rises, according to a recent Health Management Associates study.
To avoid IT issues that may arise with an influx of enrollees, states should consider switching from their legacy systems to more modern, state-based information systems, according to the report.
Here are five features and capabilities of modern Medicaid IT systems:
- Ability to manage a surge in claims and enroll newly eligible individuals quickly
- Can combine Medicaid data with the state’s health information exchange
- Embraces outcomes-based certification, which CMS is supporting to help achieve business outcomes and reduce burdens on states
- Ability to track quality of care, patient safety and health outcomes in addition to pay claims
- Allow providers to receive real-time alerts when patients go the emergency department or are admitted to the hospital
Click here to view the full report.
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