A look in the rearview mirror — and a slightly challenging proposal going forward

When a year draws to a close, I find it rewarding and helpful to take a look in the rearview mirror. I like to reflect on what was, what became, and more important, focus on what could be better.

First, let me confess that I’m a newbie to the health and human services (HHS)/fee-for-service Medicaid market. I’m celebrating my second year in this exciting area of health care. And I continue to be amazed by its complexity, the passion of its professionals, and their hopeful visions for delivering services to our fellow citizens in more tailored, efficient and effective ways.

With that in mind, please allow me to offer my own hopes and wishes for the HHS marketplace in 2020.

  1. Better recognition of technology’s assistive role in improving care. Technology can enhance numerous areas of the patient care experience, from patient engagement to care team productivity. Yet it will never replace the human touch. When doctors use technology as an enablement tool and not for technology’s sake, patients get the best of both worlds. They get data-driven insights combined with human empathy, experience and education. Delivered at the right place, the right time, and in a manner fitting to how they can best be served.
  1. Incremental modernization of a vastly antiquated infrastructure. Cooperative contracting vehicles like NASPO ValuePoint offer states a unique way to acquire a new Medicaid Management Information System (MMIS). But they also allow states to incrementally upgrade their current system in ways that offer less disruption and faster project timelines. The devil’s in the details, and creating vehicles such as NASPO requires that all participants stay within the guardrails. Those taking part need to recognize the benefits of standardizing administrative tasks.
  1. More active and open communication among states, CMS and vendors. Current procurement methods were designed to foster unbiased competition. However, they also create artificial barriers that limit vital interactions between states and vendors. Getting more project requirements defined and clarified up front instead of after a contract has been awarded could help vendors and states avoid misunderstandings. We could deliver technologies and programs more quickly and efficiently. This change would be enormously helpful. Yet it’s essentially tied up in legislative and legal compliance processes, which will make it difficult to accomplish. Oh, but a person can always dream.

Government business is complicated, and FFS Medicaid is large and important, too important to keep maintaining the status quo. My overall hope is that with a little more of the three points above, we can have a year in which we improve the timeliness, effectiveness and efficiency of our programs and services. It starts with doing something a little radical: talking to each other.

Let’s open a dialogue where we mutually define needs and acknowledge that maintaining the status quo serves no one well. Ultimately it will cost more in maintenance and lost personal care opportunities. Let’s hold ourselves accountable for what we buy and sell. And let’s avoid creating expensive legal operating conditions that increase costs and project timelines. Above all, let’s all try harder to rediscover the lost art of listening. And executing on rebuilding our health care and human services operating systems. Our citizens are counting on us.

What would you like to see for state HHS in 2020? Share your thoughts in the comments.

About the author

a.cone_img_1616Andrew G. Cone
Sr. Vice President, State Government Solutions

Andrew Cone leads solution and business development and strategy for Optum State Government.  His experience spans the health spectrum, including commercial, government (Medicare and Medicaid), payer, provider and pharmacy benefit services.  A graduate of Hamline University in St. Paul, Minnesota, his 30 + year career includes business and software development, service delivery, and consumer engagement.

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