CNSI Presents at the 2014 Healthcare Mandate Summit

February 6, 2014

Categories: Thought Leadership

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Healthcare Mandate SummitLate last month, CNSI participated in the third annual Healthcare Mandate Summit in San Diego, CA.

The conference brought together compliance leaders, pr

Healthcare Mandate SummitLate last month, CNSI participated in the third annual Healthcare Mandate Summit in San Diego, CA.

The conference brought together compliance leaders, program managers, business analysts, and technical representatives from state Medicaid IT programs. The attendees gathered to share insights on industry successes and challenges from last year and to look ahead to the goals and obstacles expected in 2014.

CNSI Senior Vice President Arvinder Singh was on hand at the event to give a presentation on the changing landscape of Medicare Advantage and Managed Medicaid.

As outlined by Singh, Medicaid expansion and a growing Medicaid-eligible population bring many business opportunities and challenges – especially ensuring that project costs are balanced by revenue recovery.

Singh’s presentation detailed the macro industry trends he’s observed as a leader in technical compliance, including the changes that come with new Medicaid eligibility groups, long-term care, and mandatory enrollment.

Each of these trends, Singh noted, will impact operations concerning flexibility in product design and pricing, the administrative complexity for eligibility and enrollment processes, and the need for enhanced outreach and interaction with enrollees.

For instance, Managed Medicaid is shifting to incorporate enhanced data exchange requirements, all with a focus on quality outcome. Singh emphasized that this change forces the industry to view health IT in a new way, moving from a “build to last” to a “designed to change” outlook.

What does that mean, you might ask? Well, for one, a primary focus of designing IT programs of the future should be user experience and information behavior. That is, how do people interpret and conceptualize data, and how can IT programs be made to adapt to those ever evolving trends?

These changes impact every aspect of business and technology operations for health plans. While there are lots of opportunities for growth, those opportunities are often met with challenges and constraints.

In order to adapt, we will need a reset of current IT approaches to enable plans to optimize operations, maximize enrollments and improve the bottom line.

As health IT moves from “build to last” to “designed to change,” in what ways will the health industry be better served? Tweet @CNSICorp to let us know your thoughts! Follow CNSI on Twitter.