Data Analytics Transforms Virginia Medicaid

By Gregory Pings, manager of Content Marketing for Xerox

No one said it would be easy, and that assessment was correct: Every state in the union has pushed their timetables back by at least 13 months.. So how does it feel when you’re the first to finish the project and go live?

Pretty darn good, according to Doug Davis, the Xerox executive account manager for Virginia Medicaid.

“This was a project of two steps forward and one step backwards,” Doug recalled. He’s talking about Virginia’s newly-launched Transformed Medicaid Statistical Information System.

When the Centers for Medicare and Medicaid Services (CMS) sent word that Virginia’s project would go live, “We looked at each other and said ‘wow- we finally did it,’” Doug said.

Do it they did. Virginia is the first and (at press time) the only U.S. state to achieve “Go Live” status with the Transformed Medicaid Statistical Information System — that’s T-MSIS for Medicaid insiders.

Medicaid produces a lot of data. Prior to the transformed information system, CMS was able to analyze only a portion of this data. But much was left out, which does not allow for good data analytics. Moreover, the Affordable Care Act mandates better Medicaid reporting from the states as a condition to receive federal funds. That’s why the long march to T-MSIS began in 2012.

The goal is timely and accurate data that allows CMS and state Medicaid directors to achieve the highest financial and program performance. This new level of data analytics will support policy analysis and ongoing improvement; identify potential fraud or waste; and enable better decisions based on reliable data.

Cat Herder or Cat Whisperer?

The complexity of the rollout was compounded by the number of partners involved – four, in Virginia’s case. Managing a complex project with multiple partners is difficult work that requires strict project management practices.

“We ran it as a structured project, which means that you set deadlines and hold people to them,” Wade Burger, System Director for Virginia Medicaid Management Information System explained.

It also means that the project team identifies responsibilities, issues and errors, and that the partners take responsibility for delivering their assignments and fixing their errors.

“Every vendor on the project agrees on what the issues are, where the problems reside, how to fix them, and who fixes them,” Bob Heffron, manager for IM Architecture said.

And fix them as soon as possible, which brings the project manager back to setting and enforcing deadlines. So how do you do that when your partners have competing priorities?

“Good rapport with key people from the other vendors,” Bob observed, “and suggestions that help develop a better system, and the work processes that surround it.”

Project management might be akin to herding cats, except that these cats sometimes were more cooperative. Doug boiled down the complexities of partner relationships this way:

“Honest conversations, structure, and working with your partners and your state,” he said. “That’s how the really hard work gets done.”

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  1. bestwatch August 14, 2015 - Reply

    Very interesting post

  2. evolutiadan August 17, 2015 - Reply


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