June 2022

Insights from Medicaid’s First and Only Training Integrator

By Adam Hayden

Why a successful MES Implementation Requires a New Approach to Training 

Systems are Only as Efficient as Users are Proficient 

In 2010, the Affordable Care Act (ACA) ushered in a new era in the Medicaid Enterprise by targeting large, legacy Medicaid Management Information Systems (MMIS) and other systems they interface with, like Eligibility and Enrollment (E&E), to be replaced with smaller, more agile systems, or “modules,” that increase flexibility, interoperability, and standardization.  

Modularity incorporates technology from many vendors. While this can ensure states get the best technology components aligned with specific functional area needs, moving from a single, customized system to discrete, more standardized modules presents a culture shift for state Medicaid agencies (SMAs), vendors, employees, and care providers.  

The need for updated state procurement processes, technology infrastructure, and data standards to meet growing interoperability requirements and value-based care models is well documented. Here we address the complexities of preparing all audiences for the change and equipping them for the future state.  

While there are clear benefits to a modular MES, people can feel overwhelmed when trying to learn and make sense of information from disconnected sources. The key is to avoid a siloed approach to training that focuses on the features and functions of individual system components.  A successful MES (Medicaid Enterprise Systems) implementation that maximizes adoption and use of the systems approaches learning holistically within the context of business processes and daily activities.  

States spend billions of dollars each year on Medicaid administration, including technology systems, but systems are only as efficient as their users are proficient. In this series of posts, we describe the role and benefits of procuring a third-party Training Integrator to support all learning audiences throughout the technology project lifecycle.  

The Psychology of Technology: The Importance of Training in a Modular MES Implementation 

Some of the most critical components of technology implementations are often not housed within the technology’s functionality but rather everything that surrounds it, including an effective organizational change management and training strategy. Or, as we like to say, the “psychology of technology.” 

Earlier this year, we facilitated a roundtable discussion at the 2022 State HIT Connect Summit (Read about a few of our HIT Connect takeaways here). Briljent’s Nick Blake was joined by representatives from the Project Management Office (PMO) of the Virginia Department of Medical Assistance Services to discuss the important role of a Training Integrator in their successful Medicaid modernization implementation, which went live in April 2022. 

Nick Blake: The Importance of Training in a Modular MES Implementation

The Roundtable centered around today’s modular environment and the mindset shift from systems to services. The MES is no longer a single solution customized to individual state requirements but is transformed into a multi-vendor environment where a PMO takes on new responsibilities of contractor and vendor management. This calls for standardized processes and well-documented workflows so that users achieve the efficiencies of a more agile environment.  

In particular, the group discussed how people would be accessing multiple system components across two internally developed MES modules and five system module vendors. With so many disparate vendors and system components, there was potential for confusion, inefficiency, resistance to change, and poor adoption.  

Participants voiced the need to strategize and plan for how to address training in this multi-vendor, multi-module environment. One participant highlighted the benefits of planning for training earlier in the process and bringing in a third-party vendor to coordinate it. A module vendor will likely have a myopic view of training based upon their individual role in the implementation and not a holistic role-based view across modules. In the same way that the Systems Integrator (SI) unifies system components, a Training Integrator unifies training and instruction from multiple vendors into one cohesive, common voice. 

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Four Unique Challenges in a Modular Environment 

We are beginning to bring to light four key challenges in MES implementation: 

  1. Sources of Training Content: Systems vendor training often focuses on features and functions, not business processes and real-life scenarios. 
  2. Readiness of the Audience: Modularity may seem more complicated to legacy system users and stakeholders. Acknowledging and addressing learner resistance, even fear of the unknown, presents a unique challenge. 
  3. Timing of the Training: Too early, and learners may not retain knowledge and skills; too late, and learners may not be proficient for system launch. 
  4. Internal Training Team Capacity: Internal training teams play a critical role in bridging old and new processes, but they can be stretched to meet the demands of a system implementation.  

Addressing these unique challenges is motivating states to explore procuring a third-party Training Integrator. We’ll dig deeper into these challenges in our next post. 

More to Come 

We’d love to share more with you, and we look forward to several face-to-face conversations during the 2022 Medicaid Enterprise Systems Conference (MESC) this August in Charlotte, NC. In the meantime, we’ll be sharing part two of our Modularity series soon. And if you really can’t wait for more, check out this recent Amazon Web Services white paper, “Medicaid Modularity: The Path to Better Outcomes.” We were thrilled to add our contributions with other partners and stakeholders.  

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