The Medicaid Management Information System (MMIS) is the heart of the Medicaid program. The MMIS processes fee-for-service (FFS) claims, managed care capitation payments, and managed care encounters. It also provides data that measures operational health and supports federal and state reporting requirements. As Medicaid programs have grown and become more complex and federal regulations more rigorous, the MMIS has been required to be more sophisticated and flexible. We provide expertise to ensure the MMIS will support day-to-day operations and meets federal compliance requirements.

Altarum has an embedded hands on project management and business analyst team at the Michigan Department of Health and Human Services that provides expertise in Medicaid policy, business operations, state and federal regulations, and software development life cycle required to support their state-of-the-art MMIS. In this role we work with the state to define innovative solutions that translate to business requirements, review functional designs, develop test plans, support internal and external stakeholder readiness, and verify that all changes made are in full compliance with federal regulations. As Centers for Medicare & Medicaid Services (CMS) regulations change and major federal overhauls like ICD-10 affect the infrastructure of the state-run system, the state needs consultants who can analyze and operationalize the business and system changes necessary to comply.

In addition to working with state and local governments on their technology infrastructure, our team has also been supporting large federal groups on specific technical transitions, such as the Veteran’s Health Administration. In this type of support role we focus on project and change management, remediation strategies, risk assessments, training, and post-implementation evaluation. We are experts in helping government entities adopt, change, or transition large technical and data subsets within their systems, while maintaining technological and HIPAA compliance.

Relevant projects include: MMIS, Medicaid Systems, ICD-10 Implementation and Illinois Michigan Program Alliance for Core Technology (IMPACT).