Who Doesn’t Want the CMS 90% Funding Match for Medicaid Care Coordination?

Now is an exciting time for Medicaid technology. Earlier this year, CMS issued a guidance letter to State Medicaid Directors regarding a 90% match for expenditures related to connecting Medicaid community-based providers to a state-funded health information exchange. According to the letter, “These provisions make available to states 100 percent federal matching funding for incentive payments to eligible Medicaid providers to encourage the adoption and use of certified EHR technology through 2021, and 90 percent federal matching funding [the 90 percent HITECH match] for state administrative expenses related to the program.”

The overarching goal of state Medicaid programs is to improve patient outcomes, improve population health, and reduce overall care costs. Traditionally this has been very difficult because providers didn’t always talk to each other. This is where the 90% match for community-based care coordination plays a key role. CMS is providing funding for helping state Medicaid programs connect non-traditional Medicaid providers to the state health information exchange infrastructure.

Care Coordination Platform

An integrated care coordination platform connects multiple providers and systems of care to a health information exchange, thus uniting medical health professionals, behavioral health providers, and community-based providers who work together with the patient to achieve desired health outcomes. Most Medicaid providers are familiar with EHRs and HIEs, but the concept of a care coordination platform may be unfamiliar. In order for states and providers to be able to collect, analyze, and use patient data for optimal impact, a community care coordination platform must bring together information from the following systems:

  • Provider Electronic Health Record (EHR)
  • Health Information Exchanges (HIE)
  • Behavioral health systems
  • Care coordination systems
  • Population health analytics

Care coordination platforms must be highly flexible in data structure, configurable for a wide variety of system needs, and feature an open API for data exchange with medical and behavioral health EHRs.

Information Gathering Sessions

There are many pieces that must come together in order for states to qualify for the 90% funding match for connecting Medicaid community-based providers to a state-funded health information exchange. In order to set projects up for success, CMS recommends that states hold information-gathering sessions with select solution providers for technology strategy, direction, insight and emerging best practices.

Eccovia Solutions has years of experience providing cloud-based care coordination solutions for government and community-based providers. We would welcome the opportunity to meet with you in an informal information gathering session and provide our vision and strategy for designing a modular care coordination infrastructure for Medicaid providers.

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