How a Health System Selected a Population Health Platform for Medicaid Program


emids helped a large healthcare organization select a new vendor and plan the implementation to meet New York State Medicaid requirements.

Overview

United Health Services (UHS) is an upstate New York integrated health system comprised of four hospitals, a senior residence, physician practices and a home health organization.

In 2016, the organization was in a pressing position to comply with New York Medicaid Health Home (MHH) program changes for managing patients with chronic conditions. UHS needed to implement a care management system to automate the health home processes in a short period of time. The IT requirements included documentation, alerts, reporting, integration and data sharing between an interdisciplinary team of providers and family caregivers. New York’s health home program requirements also included system integration with a regional health information exchange organization, enabling facilities to deliver prompt notification of an individual’s admission and/or discharge from an emergency room, inpatient or rehabilitation setting.

After attempting to select a product and manage a complex implementation, UHS realized some outside guidance and support was needed to meet an aggressive state-mandated deadline.

Solution

UHS came to us for help to find a vendor so they could get the project back on track. The project involved conducting a thorough vendor evaluation and selection process along with the pre-implementation planning work, in a short time frame. UHS selected us for the engagement given our vast knowledge and experience in software selection, planning and implementation. We have developed a methodology to conduct unbiased vendor evaluations and selection, which takes the burden off of clients and saves time. This also helps reduce project risk, as our expertise and approach identifies the best match for an organization’s needs.

The engagement included the following steps and services:

  • We documented the requirements and distributed RFQs, followed by a review of vendor responses and a functional, cost, and technical assessment of each product. We also facilitated product demos and conducted reference calls.
  • We facilitated a Decision Day, which is a framework we created to guide stakeholders through key project decisions. This framework combines industry experience with the client’s input to form a collaborative approach early on. The result is a process and conclusion that aligns the client priorities and perspectives.
  • Once the vendor was selected, we immediately kicked off the pre-implementation planning. This incorporated the creation of an integrated project plan, communication plan, change management plan, risk management plan and training plan.

Results

We helped UHS identify Netsmart as the vendor of choice to meet the New York MHH program requirements. Netsmart began work in mid-June 2017, and the joint team completed the implementation for the state Medicaid program ahead of the Oct. 1 deadline.

“When we had to cancel the original vendor agreement, we were worried about meeting New York’s Medicaid deadlines,” said Annie DePugh, director, population health at UHS. “emids took charge immediately and guided us through a sensible and thorough process for selecting the best possible vendor. The Decision Day framework is a unique and effective way to complete milestones under tight windows.”

Updating systems to meet new industry requirements is always challenging. Our proven methodology for vendor selection and robust project management, change management and training processes helped UHS ensure ongoing Medicaid reimbursement revenue streams.

Sign up to receive our latest insights